CONTACT INFORMATION
Company Name:			Address:
Telephone:			Fax:
Contact Name:			Position:
E-Mail Address:			Direct Dial #:
MACHINE OEM SPECIFICATIONS
Make:			Model Number:
Machine / Press /  Line / Extruder #:			Year of Manufacture:
Clamp Tonnage:			Injection Unit:
Over All Length:			Diameter:
PROCESSING REQUIREMENTS
Type of Resin to be  processed:			Melt Index:
Filled Material?	Yes        No		If yes, what type of filler?
COMMENTS

Not all the missing dimensions on the Quote Request Print need to be provided in order to prepare a quote.
Please provide as much information as possible.

Non-Return Valve Quote Request Print