TUBE-NUT ATTACHMENT QUOTE REQUEST FORM #3A Page 1 of 2 Date _____________________________
PLEASE COMPLETE BOTH SIDES Name ________________________________________________________________ Phone ________________________________Fax ___________________________
1886 Larchwood Dr. Troy, MI 48083 Fax (248) 526-0019 (248) 526-8100
Company _____________________________________________________________ Address ______________________________________________________________ City _________________________ State ______________ Zip ________________ Country ______________________________________________________________
Dimensions - Give Maximum Allowable
Dimensions - Give Maximum Allowable
A:
_________IN
_________MM
F:
________IN ________MM
B:
_________IN
_________ MM
G: (Tube Size)
________IN ________MM
C:
_________ IN
_________MM
Hex Size:
________IN ________MM
D:
_________ IN
_________MM
Hex Extended?
________IN ________MM
E Std: Size dependent on power tool selected
Square Drive Size: ________IN ________MM
E Optional Extension: _____IN _____MM If necessary, can a sample of the part be sent for our review? ____Yes ____No
Torque Output Requirement: (Fill in one only) Fastener Torque Requirement _________Inch/lb. _________Foot/lb. Is This Fastener Application _______Hard Joint _______Med Joint
__________NM _________KG/CM _______Soft Joint
Š Copyright 2000 Jemms-Cascade, Inc. 1886 Larchwood Dr., Troy, MI 48083 USA (248) 526-8100 Fax (248) 526-0019