Request for Quotation On
Product Name or Description
National Stock Number (NSN)
Cage Code for Item and/or Part No. and/or Drawing No. with Rev. Code
Quantity Required
Required Delivery Date
Quantity Unit Pack (QUP):
Activity/Organization or Firm Name
Your Name and/ or Buyer Code:
Request for Quote Number (RFQ):
Purchase Request Number (P/R):
Ship to (City, State and Zip Code)
FOB Point
Destination
Origin
Is this an IMPAC Purchase
Yes
No
Is Government Source Inspection Required?
Yes
No
TO CONTACT YOU, I WOULD
Telephone you at
Fax you at
E-Mail you at
