Fax Quotation for Heat Shrink
* Bold Fields required

Fax To: 1-800-438-9562

*Company:

*Requested By:

Position:

Email:

Street:

*City:

*State:

Country:

*Zip:

*Telephone:

Extension

*Fax:


Application: Please check all that apply
Electrical	Medical	Aerospace	Environmental	Bid Only
Industrial	Military	Semiconductor	Instrumentation	Firm Order

Material: Color: Filler: If Other, Please Specify:

*Heat Shrink Dimensions			You must fill in 2 out of 3 in order to receive a quote.
* Exp ID:		Tolerance:			Product will be quoted with standard TexLoc tolerances unless otherwise specified.
*Rec OD:		Tolerance:
*Rec Wall:		Tolerance:

	*Supplied as:	If Length, please advise:	Length Tolerance:


Annual Quantity:		Customer Part Number:
*Quantity per Release		Description:
Application: Size of the component you are recovering the heat shrink onto: Recovery Method: If Other, Please Specify: Recovery Temperature: Recovery Time: Sterilization Method: Parker-TexLoc, Mfr. of Precision Fluoroplastic Tubing & Heat Shrink 4700 Lone Star Blvd. Fort Worth, Texas 76106 U.S.A. Telephone: 817-625-5081 U.S.A. 800-423-6551 Fax: 817-624-9095 U.S.A. 800-438-9562 Email: texloc@parker.com