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Company Name:
Address1:
Address2:
Main Phone Number:
Main FAX Number:
Main Email:
Website:
Primary contact:
Phone Number: Ext.:
Email:
Engineering Contact:
Phone Number: Ext.:
Email:
How did you learn about ControlTek?

Part Number: Revision:
Board Length:
Board Width:
Board Thickness:

Quantities to be quoted:


 Requested Delivery Schedule:
Qty Date Qty Date Qty Date
by by by
by by

 Items supplied by customer Yes No N/A  
Case/Enclosure Mechanical Drawing (DXF/IGS)  
PCB Mechanical Drawing (DXF)  
Schematic  
PCB Gerber Date  
X, Y, Theta (Centroid) Data  
B.O.M.  
Stencil Gerber Data  
Stencil  
Bare PCB's  
Partial Components  
Complete Components  
Test Fixture  
Cases/Enclosures  
Packaging  

Assembly Details . If customer supplied
 SMT Discrete Components Side A Qty Side B Qty Tape/Reel Bulk
Chip Components (0201)
Chip Components (0402)
Chip Components (All Others)
MELF's
Small Outline Transistors (SOT, SMT)

If customer supplied
 SMT Components Side A Qty Side B Qty # of I/O's Pitch Tape/
Reel		 Tube Waffle
Tray		 Bulk
Plastic Ball Grid Array (PBGA)
Chip Scale BGA (CSBGA)
Micro BGA
Quad Flat Pack (QFP, BQFP, LQFP, CQFP)
Leadless Ceramic Carrier (LCC)
Plastic Leaded Chip Carrier (PLCC)
Small Outline IC (SOIC)
Thin Small Outline Pkg (TSOP)
Small Shrink Outline Pkg (SSOP)
Other

If customer supplied
 Through Hole Components Side A Qty Side B Qty Axial Radial Tape/Reel Tube Bulk
< 4 leads
> or = 4 leads
Hardware (heat sinks, fasteners, standoffs, etc.)

Yes No
Wiring Harnesses or Assemblies Required?
Mechanical/Optical Assembly Required?
Special Packaging Required?

Special Instructions and Comments:


 
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