Pricing Information

Please complete the following checklist to provide us with the necessary information to process your request for pricing information. Please click the "Submit to Pines" button at the end of the checklist when you wish to send the request for a quote to Pines.

	With what can we help you:
	Name: *
	Company Name: *
	Phone: *
	Fax:
	Mailing Address:


	E-mail Address: *

	Material Description:
	Min/Max. Wall Thickness:
	Min/Max. O.D.
	Min/Max. Tube Length:
	Center Line Radius:
	Max. Bend Angle:
	Number of Bends:

	Is this a new application (job)?	Yes No

If new application, please describe elongation requirements:

	Mandrel:	Yes No
	Expected Production Rate:
	Number of Shifts:
	End Product:
	How soon will you need a machine:
	Max. length of workpiece over the mandrel rod:
	Motor Electrical Requirements:	Voltage Phase Frequency

Do you need additional Information?

Thank you for your interest in Pines benders.

The information you requested will be mailed to you promptly.
Please Fax or send drawings or set of prints to Pines at:
Fax: (440) 835-5556 or
Attn: Sales Department at 30505 Clemens Rd. Westlake Ohio 44145