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Request for Quote Form
Request for Quote
Name Company Name
Title Company Address
Phone  
FAX E-mail
How did you come to our website?  search  referral  advertisement
other: 
WILL A DRAWING OR SPEC BE SENT? (this is a must for multi-lumen tubes)
 YES  NO
Type of tube:  single lumen  multi-lumen  braided  stripe  coextrusion other: 
Application
Size and tolerances and other specifications
OD:  +/-: 
ID:  +/-: 
WALL:  +/-: 
 inch  mm
Cut to length:  +/-: 
Spooled: quantity: 
Material:  other: 
Grade or Hardness (if known):   Shore A  Shore D
Suggested material supplier (if known): 
Color: 
R/O filler:  no yes, specify: 
other: 
Properties of material (if material not specified above) other: 
Material (inner layer or stripe):  other:  Grade or Hardness (if known):   Shore A  Shore D
Suggested material supplier (if known): 
Color: 
R/O filler:  no yes, specify: 
other: 
Braiding material: 
size: 
# of strands: 
pics per inch: 
Length and tolerance: 
Spooled: How many feet per spool: 
Roundness (diameter measurements) Min and max must be in spec?  Yes  No
Only average compared to spec?  Yes  No
Concentricity:  How measured: 
Straightness: Is there a spec?  no
If yes, specify how measured: 
Any other finishing requirements?
Quantities to quote:  Annual Qty: 
Packaging: any special requirements?
Other
Can we add you to our homepage update file?
This is a subscription feature. If you choose to join our update notification we will send you an e-mail inviting you to visit the specific page(s) that have been changed, like our news page or tube of the month page. You will not automatically recieve e-mail from PEI without signing on for this feature. You will not recieve unsolicited SPAM. Your contact information WILL NOT EVER be sold to or shared with anyone else.
Sample Request
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Information / Contact Request
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12 Glens Falls Technical Park
Glens Falls, NY 12801
Phone: (518) 792-1199
FAX: (518) 792-3805
Email: sales@precisionextrusion.com

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