DRIVE TEST PLATES - QUALITY CONTROL
FINIAL INSPECTION
FAX ORDER FORM
2 X 6 INCH SHAPED PLATES SAVE - LOWER PRICES FOR BLANKET ORDERS
CERTIFICATIONS ARE INCLUDED WITH EVERY SHIPMENT ISO 9000 CERTIFIED MATERIAL SUPPLIERS
             Thread Cutting Screws                  Thread Rolling Screws  
                   Types 1, 23, D, F, G, T                Types TT, SW, SF, RL, TR3, CF, Tri-Pt  
 Plate Num. Order   Hole     Plate Num. Order   Hole  
 Number Holes Qty  Price Diameter Thickness   Number Holes Qty  Price Diameter Thickness
 TC-4-40 48     0.0960 0.109   TR-4-40 48     0.0980 0.125
        5-40 "     0.1010 "          5-40 "     0.1100 "
        6-32 "     0.1200 0.140          6-32 "     0.1200 "
        8-32 "     0.1470 "          8-32 "     0.1470 0.187
        10-24 "     0.1730 0.187         10-24 "     0.1660 "
        10-32 "     0.1770 "         10-32 "     0.1720 "
        12-24 38     0.1990 "         12-24 38     0.1910 "
        1/4-20 "     0.2280 0.250         1/4-20 "     0.2190 0.250
        1/4-28 "     0.2340 "         5/16-18 17     0.2770 0.312
        5/16-18 17     0.2900 0.312         3/8-16 "     0.3390 0.375
        3/8-16 "     0.3580 0.375        M35-06 48     0.1240 0.125
        M4-07 48     0.1380 0.140        M4-07 "     0.1420 0.187
        M5-08 "     0.1770 0.250        M5-08 "     0.1790 0.250
        M6-10 38     0.2125 0.250        M6-10 38     0.2125 0.250
       M8-125 17     0.2875 0.312
                    Tapping Screws    
               Types A, AB, B, BF, Type 25 Please Complete Below
 Plate Num. Order   Hole      
 Number Holes Qty  Price Dia. Thickness    Company          
 TS-3 48     0.0810 0.048    Street          
       4 "     0.0860 "      
       5 "     0.1065 "    City      State    Zip  
       6 "     0.1160 0.075      
       7 "     0.1285 "    Phone      FAX      
       8 "     0.1360 "      
       10 "     0.1590 0.125    Buyer            P.O. #    
       12 38     0.1875 "      
       14 "     0.2165 "  Date      Dely
       1/4 "     0.2165 0.187    Order Calculation           Amount
       5/16 17     0.2720 "            $    
       3/8 "     0.3280 "   QTY            @        
       M4.2-1.41 48     0.1360 0.075   QTY            @        
       M4.8-1.59 "     0.1590 0.125   QTY              @        
       M6.3-1.81 38     0.2165 0.187   QTY              @        
  QTY              @        
THE RAW MATERIAL EXCHANGE   TOTALS             $    
210 Shorewood  Drive, Valparaiso, IN 46385 5-27-03
PHONE 219-464-2259       FAX 219-465-4110