Request for Quote

Thank you in advance for considering EDM for your project. In order to minimize the time required to return a formal quote to you, please prepare as much of the following items listed below in advance before filling out and submitting our Quote Form:


Company Name	Contact Name

Engineering Contact Name	E-mail Address

Phone Number	Fax Number

Quote Due Date	Product Name or Number
Ex: 01/02/2009

Quantity Requested


Updated Bill of Material, Gerber Files, Assembly Drawings

____________________________________________________________
RoHS
Yes No

Are there Programmed Parts


Special Packaging Requirements


Is Product Tested
Yes No

If testing required please provide details (time required, specific test instructions)


If testing required, is Test equipment provided by EDM or Customer?
Yes No

General Comments

When we need an order ASAP, EDM always comes thru. Their customer service is excellent!

Buyer

Medical

12202 Cary Circle

La Vista, NE 68128

Phone: 402.334.8120

Fax: 402.334.0726