Oval Single Lumen Extrusion Request Form

PART ONE - ORDER INFORMATION
Request Date
Requester Company
Requester First Name
Requester Last Name
Phone
Purchase Order #
Reference Document
Product Application
Ship To
PART TWO - MATERIAL DESCRIPTION
WT%
POLYMER TYPE
TRADE NAME
GRADE NUMBER
ADDITIVE / COLORANT
%
%
%
%
PART THREE - PACKAGING
Final Quantity
[Select One]
Qty Reel(s)         Length on Reel each 

-OR-

Qty of cut Pieces         Piece Length

PART FOUR - PRODUCT SPECIFICATION
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Oval Single Lumen Extrusion

ID Min
OD Min
ID Max
OD Max
Walls
Concentricity Greater than or eqaul to %
Comments 

You will receive a cost quotation via email within 24-36 hours or less.