• Please provide the following contact information:

Name
Title
Organization
Street address
Address (cont.)
City
State/Province
Zip/Postal code
Country
Work Phone
FAX
E-mail
URL

• Please provide the following product information:

•  

Part Number
Revision
Quantity	Min   Max

•  

Material Type

Overall Board Thickness

 

•  
• IPC Class
• I II III        

• Is Board U/L Certified ?
• Yes No
•  
• Board Sizes
• Numbers of Holes per Board
• Number of Drill Hole Sizes
• Board Type
• S/S D/S M/L OTHER ;  
•  
• If S/S or D/S Board what is Copper Ounce
• .5 1 OZ. 2 OZ. 3 OZ. 5 OZ.
•  
• If M/L How Many Layers
• 2  3 4 6 8 10 OTHER   

 

If board is a multi-layer, please include a brief description of the lay-up as well as copper ounce for each layer. Below is an example of a typical 4 layer board.  Lay-up Copper oz. comp. 1 oz.. power1 .5 oz. power2 .5 oz. solder 1 oz.

• Is Board in an Array?
• Yes No
• Does Board have SMT Pads ?
• Yes No
• If Board has SMT pads which Sides
• S/S  D/S    
• If Board has SMT Pads, what is Pitch.
• Solder Mask?
• N/A  S/S D/S COMP. SIDE SOLDER SIDE    
• Silk Screen ?
• N/A  S/S D/S COMP. SIDE SOLDER SIDE  
• Does Board Get Gold Plating ?
• Yes No
• What areas are Gold Plated ?
• Tab Plated Whole Board

Please enter any additional information, needed to quote this order for you.

Thank You for Your Interest in Harmon Industries, Inc. Circuit Board Division.

If by chance this form does not properly work or your system does not support forms. You can Save this form as an HTML Document and Email it to: [email protected]

You can also send it by FAX to (660) 747-2238 ATTN : Sales Dept.