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Quotation Form

Quotation Form

(*) Denotes Required Fields

Company Name *

Contact Name *

Phone Number *

Email Address *

RFQ Number

Part Number

Glass Type *

Part Shape *

Disc Rectangle Ellipse Prism Lens

Dia/Lgth and tolerance

Width and tolerance

Thi and tolerance

Other

Other

Material Quality

Index Tolerance

Dispersion Tolerance

Stress Birefringence

Bubble/Inclusion Spec

Striae Spec

Homogeniety Spec

Other Specs

Required Quantities *

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Glass Fab, Inc. PO Box 31880 Rochester, NY | Telephone: (585) 262-4000 | Fax: (585) 454-4305 | info@glassfab.com

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