Quote Request Form

(cm3)

FOB Destination

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Quote Request Form (Red Fields are
Required)

Company Name:

Address Line 1:

Address Line 2:

State/Province

Postal Code:

City:

Contact Name:

Phone:

Fax:

E-Mail Address:

Part Number:

Rev:

Part Name:

Est Annual Usage:

Est Monthly Usage:

Material 1:

Color 1:

Material 2:

Color 2:

Material 3:

Color 3:

Part Weight.

(g)

Part Volume

Pin Type :

Terminal Size:

Pin Size:

Terminal Type:

Qty/Part:

Qty/Part

Delivery Required:

FOB Origin:

Drawing Attached

Quality System Required:

Standard Inspection

Best Commercial

ISO-9001:2008

Other Quality System Required, Please Specify:

Comments or Special Instructions:

USA
Plasti-Coil, Inc.
901 Geneva Parkway North,
Lake Geneva, WI 53147,
U.S.A.
Tel: 1-262-249-5620
Fax: 1-262-249-5630
Email: info@plasticoil.com
ISO-9001:2008 Certified

Hong Kong
Plasti-Coil (Asia) Co., Ltd.
Unit 2301, 23 Floor,
Chuang's Enterprises Building
No. 382 Lockhart Road, Wanchai,
Hong Kong
Tel: 852-2110-8193
Fax: 852-2110-8608
Email: sales@plasticoil.com.hk

CHINA
Foshan Shunde Plasti-Coil Co., Ltd.
Block C, 1 Jie Fang Road,
Xi Chong Countryside, Lun Jiao,
Shunde, Foshan, China (Post Code:
528308)
Tel: 86-757-2733-6673
Fax: 86-757-2733-6687
Email: factory@plasticoil.com.hk
ISO-9001:2000 Certified