Laird/Sager Sample/Quote Request Form
O'Donnell Associates North, Inc.
Distributor Name:
Sager Electronics
I/S Contact:
*
Phone:
*
Email address:
O/S Contact:
Phone:
Email address:
*
Customer Name:
*
Contact:
Address:
City, ST, Zip:
Phone:
Email address:
*
Contract Mfg. Name:
Contact:
Address:
City, ST, Zip:
Phone:
Email address:
Action:
Sample:
Quote:
Part Number(s):
EAU:
Program Name
Proto Date
Application
Production Date
Sample Quantity
Quote Quantity
Competition
Meet Comp Price
*
Please complete.