Quote Form

Company Name: Requisition:
Phone: Material:			Fax: Part #:

Description:	Grade:	Anneal:	Bubble Spec:	Index Spec:


Geometry of Part:			Tolerance:
Diameter(length): Thickness: Width: R1 (+/-)			R2 (+/-)

Surface Required:

Quantity: pcs pcs pcs

Delivery Date: RFQ Due Date:

Prices valid based upon material availability and current pricing from supplier.

John Fisher, VP of Advanced Glass Industries in Rochester New York