Standard Please Complete & Return With Raw Material
Plaque
Inc. Customer Job Requisition
Company Name:______________________________________
___________________________________________
Contact:_________________________
Phone:__________________________
Fax:_____________________________
Material Type:____________________________
No. of Materials:_______________________
Lbs______
Size & No. of Specimens Requested:_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Job#____________________________
PO# ________________________________________________
Ship to:
Street:________________________________
City:_____________________________
State:_____
Zip:__________
Bill to: check / / here if same as above
Street:________________________________
City:_____________________________
State:_____
Zip:__________
Manufacturer Recommended Molding Parameters:___________________________________
___________________________________________
Melt Temperature:
______________________________________________________________
Mold Temperature:
______________________________________________________________
Additional Parameters / Drying Conditions: ___________________________________________
___________________________________________
___________________________________________
Note: material safety data sheets and purchase order required for all materials prior to start of project.
Billing/Shipping: 17271 Francis St. Melvindale, MI 48122
Phone: 313-383-7233 Fax: 313-383-7429 Website: www.standardplaqueinc.com