Omega Plastics Quote Request Form



Please note: Although it is most unlikely that you will experience any problems responding to this form, certain non-standard browsers will not respond properly. If you experience any difficulties, (or if you are not using a forms-capable browser) you may email your response to this form to: webmaster@omegaplasticscorp.com.

Fill in the following information as completely as possible. Explain extra details in the comments box. If you have drawings that need to accompany this quote request... fax them to us at the Fax number listed at the bottom of the page or attach them to a separate E-Mail and send them to us.

Contact Information
Name:	Company:
Title:	Email:
Address 1:	Address 2:
City:
State/Prov:	Postal Code:
Phone:	Fax:



Profile Information

Part Number/ID:		Length (in.):

Part Description:
Estimated Units Per Average Order (Ft. or Pcs.):
Estimated Annual Units (Ft. or Pcs.):

Material:	Color:

Product Application/Description:
Packaging Requirements:
Fabrication Requirements:
Additional Comments:

If a drawing is available for the part in question, please fax it to 574-522-4696; ATTN: QUOTE. Make sure to reference the same part number/ID as entered above!

Thank you for allowing us to quote your material requirements....We will respond soon.