Haeger Custom Tooling Request for Quotation Form

A PennEngineering® Company


Items in RED must be filled in

Name:
 

Distributor:
 

Salesperson:
 

Email Addresses:
   

 

 

Customer:
 

Contact Name:
 

Phone Number:
 

Ext.

Description of Tooling Requirements (Desired type of tooling - Automatic Top Feed, Automatic Bottom Feed, manual, J-Frame, etc.):
 

Is this tooling for an installed machine?
 

Is this tooling for a robot-ready machine?
 

Original Order Number (for replacement parts):

Haeger Model:
 

If Other:

MAS Size:

Fastener Information

Fastener Manufacturer: ( , PSM, Hank, Kalei, Strux, Captive, Kerb, Konus, etc. - 25 to 300 samples may be required):
Fastener Part Number: (If no part number, please attach a signed spec/tolerance sheet):
Description

Part Information

Part Description: (Flat, Formed, Reverse flange, to be inserted in the flat, fastener near flange, etc. - part may be required.):
 
Part Material:
 

Attachment(s) (Please attach any applicable drawings of sample parts or specifications needed -- file formats such as DWG, DXF, PDF, and DOC are preferred)