Name:

Company:

Building #, Street, City, State, Zip

Country:

Phone:

Fax:

E-mail address:

Would you like to be on our mailing list?

Would you like us to mail you our literatutre package?

Yes No

Yes No (US Postal Service)

Unless you specify otherwise (in the Special Requirements section below) all work will be performed to Best Commercial Practice.

Please answer all questions which apply to your request.

If you are unsure about a question, respond with a "?".

RFQ number:

Date quote required:

1. Check all that apply

 

Circuit Board Design

PCB Fabrication

Quantities

PCB Assembly

Quantities

Component Procurement

Quantities (Kit Quantities)

2. Application
 
Multilayer:
Number of layers:
Multiwire:
Wire Wrap:
Other:
3. Circuit Board Specifications
 
Part Name / Number:
Board Type: Rigid:
Flex:
Rigid / Flex:
Board Material: FR-4:
Polyimide:
Teflon:
Other:
Dimensions:
example (9" x 12" )
Board Thickness:
mils
Silk Screen:
sides
Controlled Impedance:
Yes No Ohms Tolerance (%)
Buried or Blind vias:
 Yes No Desription
Body or Tab Gold:
Yes No Desription
Total Pin Count:
Total Hole Count:
Total Signal Net Count:
Smallest Trace Width:
mils
Smallest Space Between Traces:
mils
Smallest Hole Size:
mils
Component Types: Through Hole Only:
SMT Only:
Through Hole and SMT:
Component Placement: Components Single Side:
Components Both Sides:
Number of Components: Top Side: :
SMT PTH
Bottom Side
SMT PTH
4. Delivery and Special Requirements:
5. Deliverables:
 
Standard Documentation:
Optional Items:
6. Optional Information: