ENG Electric custom switching supply RFQ

Custom "Switching" Adapter
Request-for-Quote form

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Adapter Type:
Complete this section for Desk-Top requirements only:
	Inlet Receptacle:
	Quote on the input cord? yes no
	Input Cord:

Continue for both Wall-Mount and Desk-Tops:
Input Prongs:
Input Voltage (AC):
Output (DC):		DC
Output Voltage:
Output Current (mA or A):
Output Regulation:		Regulated
Output Cord:
Output Plug:
Output Plug Length:
Output Plug Polarity:
Ambient Temperature:
Safety Agency Approvals:
Additional Notes:

Quantities to quote:
	1k pcs	2.5k pcs	5k pcs
	10k pcs	25k pcs	50k pcs
Other quantites:
Project Name:
Quote FOB Point:

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First Name:
Last Name:
Company:
Email:
Telephone:
Fax:
Position:
Street Address:
City:
State:
Country:
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