Order Form

PMS Number *

Log Number *

Product Number *

Pricing

Chips: *

Flim *

Sample

Customer *

Sales Person

Contact *

Telephone Number *

Fax Number

Email *

Address

Date Submitted *

Date Required *

Quote Quantity lb/kg *

Yearly Volume lb/kg *

Desired Product *

Concentrate *

LDR% *

Colour

Customer Resin Type *

Acceptable Carreirs *

Melt *

Filler *

Filler % *

Customer Process *

Max Temp *

Other

Slip

Antioxidant

Antisat

Anitblock

Other

FDA/HPB

HMF

Other

Visual

Critical

Instrument

Commercial

Cust. Spec.

Opaque

Transparent

See Sample

UV Stable Pigments

Time

Location

UV Additive For Resin

Time

Location

Additional Requirements