REQUEST FOR QUOTATION
TO: ATTENTION: COMPANY FAX NUMBER: ITEM QUANTITY __________________________________________________________________________
COMPANY NAME
___________________________________________________________________________ __________________________________________________________________________
DATE QUOTE NEEDED BY: ___________________________________________________________________________ UNIT DESCRIPTION DELIVERY UNIT COST EXTENSION TIME ARO INCL SHIPPING
QUOTATION VALID FOR _____ DAYS
Freight Terms: FOB Destination
Subtotal Applicable Tax
The Successful Vendor may be required to provide a certificate of insurance naming MCCD as an Additional insured
Shipping TOTAL
INCLUDED
SIGNATURE OF COMPANY REP: __________________________________________
DELIVERY SITE: ADDRESS: ATTENTION:
DATE: _______________________
__________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ FAX QUOTATION TO: _________________________________
Rev 12/98
PHONE: ____________________________________