Custom Quote Form - Harkness Industries

	Custom Urethane Examples
	Request for Quote

Quote Form for Custom Urethane

*Indicate Required Field

*Company Name:

*Contact:

*Telephone:

*E-mail:

Fax:

Company
Location :

Section #1 - New Parts

1. Part drawing available:

Yes No 2. Drawing Date: / /

3. Drawing available in:

CAD PDF

other format

4. All dimensions toleranced:

Yes No

5. Faxing drawing or email

6. Describe Application:

7. Reason for requesting urethane (check all that apply)

Uses urethane in similar application		Replacing Other
Requires load bearing capability		Maximize flex fatigue
Requires maximum abrasion resistance		Tear strength
Replacing Nylon, UHMW		Other

Faxing: Drawings lose clarity with each subsequent transmittal. Please be sure that you can clearly read the notes, dimensions, and tolerance block.

Email: Harkness can view the following file types: .dwg, .dxf, .dwf, .pdf, .sldprt, .sldrw, .drw

Section#2 - Existing Parts

1. What's the customer's reason for wanting to change suppliers (check top 1 or 2 concerns)

	Urethane part performing poorly			Supplier consistently ships late
	Long lead times			Poor quality
	Inconsistent Quality			Reduced price

2. Does the customer own the tooling: Yes No - If Yes, #of Cavities
If no, will the customer buy new tooling: Yes No

3. Part drawing available:

Yes No 4. Drawing Date: / /

5. Drawing available in:

CAD PDF

other format

6. All dimensions toleranced:

Yes No

7. Faxing drawing or email

Section #3 - Commercial Requirements

1. Number of parts to be quoted: Qty.#1 Qty.#2 Qty.#3

2. Est. yearly usage 3. Release quanity 4. Target price

5. First article required: Yes No

6. Required Date of 1st Delivery: / /

7. May we contact your customer: Yes No
Company Name: Contact: Phone:

Harkness Industries
1-800-343-4275 • Phone: 203-272-3219 • Fax: 203-272-0428
50 Grandview Court • Cheshire, CT 06410