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Quotation Request
* indicates a required field
*Name
*Company
*Address
Address Continued
*City
*State
 Country
*Postal Code
*Telephone
*Fax
e-Mail
Dimensions

Please indicate Inches () or Millimetter (mm)

*Outer Diameter
*Inner Diameter
*Wall Thickness
*Length

Positive Tolerance

Positive Tolerance

Positive Tolerance

Positive Tolerance

Negative Tolerance

Negative Tolerance

Negative Tolerance

Negative Tolerance

Please Fax or send Drawing as e-Mail Attachment

*Material

If Other

Material Grade
Radio-Opacifer
Barium Sulfate

Manufacturer

If Other

Tungsten
Other

Hardness

If Other 
Color
Sterilization
*Quantities Required
Order Frequency
Certification Requirements
Special Packaging Requirements