Request for Quotation Form

Completing the form below will provide Nelson Specialties Company with the data necessary to accurately quote your project(s). If any questions arise regarding this form, please do not hesitate to call (269) 983-1878 ext. 11.
Thank you for the opportunity.

NOTE: For PCB Assembly and Mechanical Assembly Quotations, please provide: Schematics, Bill of Materials, Parts Specifications, Quantity, and Delivery Date, if available. Please email documentation by clicking on the corresponding email link OR fax it to 269-983-1890.

Contact Information

< Required fields marked with >

 First Name:

 Last Name:

Title:

 Organization:

Street Address:

Mailing Address:

City / Town:

State / Province:

Zip / Postal Code:

Country:

 Phone:

Fax:

E-Mail:

Project Requirements:

 

Immediate, project ready to go

 

Within 1-3 months

 

Over 3 months

 

Budgetary only

General Information

a) Part Name and Number:

b) Please quote the following items:

 

PCB Assembly Only
(Please email or fax to: (269) 983-1890, your Bill Of Materials)

 

PCB Assembly & Material
(Please email or fax to: (269) 983-1890, your Bill Of Materials)

 

PCB Fabrication

 

Other

PCB Fabrication Information

a) Layer Count:     One      Two        Other

b) Material:            FR-4     CEM-1     Other

c) Material Thickness (inches):      Other

d) Dimensions (inches):                    X 

e) For Thru-Hole:

      Approx. # of Holes:   Smallest Hole Size (inches):

f) If Surface Mount Parts - Qty SMT Pads:

      Qty. Top Side:                  Qty. Bottom Side:       

g) Min. Trace Width (in mills):    Min. Spacing (in mills):

h) Silk-screen:             Top Side         Bottom Side         Both

i) Soldermask:             Top Side         Bottom Side         Both

j) Copper Weights:      1 oz.          2 oz.        Other

k) Fabrication Turn Time:

Days:     1   2   3   4

Weeks: 1   2   Other

l) Quantity of PCB's Required:      

   Please enter any special requirements or notes:

We provide accurate PCB assembly using state of the art equipment operated by qualified, well trained employees.

PCB Assembly Information

Component count:

  Top - Quantities:          SMT Qty:     Thru-Hole Qty:

  Bottom - Quantities:    SMT Qty:     Thru-Hole Qty:

  Quantity of Assemblies Required:   

  Assembly Turn Time Requested:     

Assembly Quote will require a Bill of Materials.
Please email or fax to (269) 983-1890

   Please enter any special requirements or notes:

       

All information submitted to Nelson Specialties Company will remain confidential. Quotations are valid for 30 days.
 

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NELSON SPECIALTIES COMPANY
211 Hilltop Road - Door 16
St. Joseph, Michigan 49085 USA
Office (269) 983-1878
Fax (269) 983-1890
Email info@nelson-specialties.com