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Retractile Cord Worksheet
1)
.
Type of Retractile Cord:
Power
Communications
(Electronic)
(select one)
2)
.
Conductor Insulation Material to be Used:
Rubber
TPE
Polypropylene
PVC
(select one)
3)
.
Jacket Material to be Used:
Rubber
Neoprene
Polyurethane
PVC
TPE
(select one)
4)
.
AWG Size and Number of Conductors
5)
.
Type of Stranded Conductor:
Bare Copper
Tinned Copper
Tinsel
(select one)
6)
.
Shielding Requirements:
Spiral Serve
Foil Tape with Drain Wire
None
7)
7A
.
Retracted to Extended
Length:
to
7B
Cord Dia./ Coil
O.D.
7C
Length of Straight
Tangent Ends:
7D
Remove Outer Jacket
(R.O.J.) Dimensions
7E
Conductor Strip
Dimensions:
7F
If Conductor is
Twisted and/or Tinned, Specify.
7G
Terminals?
7H
Strain Relief Requirement?
.
8) EAU/Quantity to Quote?
9) Target Price?
10) Will our AutoCad Print be Required for Approval?
Yes
No
11) Will a First-Article Sample be Required for
.......
Approval?
Yes
No
12) Can You Submit a Sample Cord, if Necessary?
Yes
No
13) Upon Approval of Quote/Sample, How Long Until "Buy" is Made?
14) Would you like us to contact you to discuss?
Yes
No
15) Comments
Contact Information:
*
Name, First
*
Last
*
Company
*
Title
*
Address 1
Address 2
*
City
*
State/Prov.
*
Zip/Postal Code
*
Country
*
Telephone
Fax
*
email
(Fields with * are required)
Post Office Box 910, Pickerington OH 43147-0910
Phone: 614-920-0852, Fax: 614-920-0857, email: sales@hightechcords.com
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