Request for Quote

• Name:
• Company:
• Phone:
• Fax:
• Email:
• Quote Requested By:

• Address:
  
• City:
• State:
• Zip:
• Target Delivery Date:

How Did You Hear About Cass Screw Machine Products:
Select One... Current Customer Former Customer Referral Web Search Thomas Register Yellow Pages Other

Part Information (4 Max each Form)

(Please send drawings as .pdf, .doc, .tcw, .dwg, .jpg, or .bmp format)

• Part #1:
• Description #1:

• Part #2:
• Description #2:

• Part #3:
• Description #3:

• Part #4:
• Description #4:

Please include any other information like special packaging, plating or handling requirments not indicated on the print here:

• Qty1:
• Qty2:

• Qty3:
• Qty4:

Attach Files: (4 Max)

Additional Information:

Please type the numbers and letters that you see below: