QUOTATION REQUEST
Please provide the following contact information:

Name:
Title:
Organization:
Address:
Address 2:
City:
State:
Zip:
Country:
Work Phone:
Fax Number:
Email:

QUOTATIONS REQUESTED:

New Injection Mold
Expected Annual Volume:
Number of cavities to be quoted: One   Two   Three   Four   Other:


Custom Injection Molding
Optical Quality Polycarbonate
Standard Engineering or Commodity Resin Molding
Expected Annual Volume:
Typical Release Quantities:   Per: Month   Quarter   Other:


Coating Services
Material to be coated: Polycarbonate   Acrylic
Abrasion Resistant   One Side   Entire Part   Portion
Anti-Fog   One Side   Entire Part   Portion
Anti-Fog Inside/Anti-Scratch Outside
Vacuum Coating
Expected Annual Volume:
Typical Release Quantities:   Per: Month   Quarter   Other:


Part Stamped from Coated Extruded Flat Polycarbonate Sheet
Anti-Scratch   One Side   Both Sides
Anti-Fog   One Side   Both Sides
Anti-Scratch One Side/Anti-Fog Other Side
Expected Annual Volume:
Typical Release Quantities:   Per: Month   Quarter   Other:


Post Production Services
Decoration
Assembly
Packaging
Other


Drawings and/or Specifications Available?: Yes No
If Yes, FAX E-mail (*.pdf format preferred) or Snail-mail to address below


Existing Sample Parts Available?: Yes No
If Yes, Please forward to address below


Forward Snail Mail To:MXL INDUSTRIES, INC.
1764 Rohrerstown Road
Lancaster, PA 17601
ATTN: Sales: Quotations
800-233-0159
717-569-8711
FAX:717-569-8716
E-Mail:sales@mxl-industries.com

Comments, Notes, Questions:

MXL Industries, Inc. - 1764 Rohrerstown Road, Lancaster, PA 17601
Toll Free: 800.233-0159 - Local: 717.569.8711 - Fax: 717.569.8716 - Email: sales@mxl-industries.com