Request For Quote

To help us best to serve you, please provide the following information for a prompt response to your RFQ.

Your Contact Information:
Company Name
Contact Name
Phone
E-mail Address
Product Information:
Estimated Annual Usage
Quote Quantities
Is this a production or prototype product or both?
	Production   Prototype   Both
Date Quote is Desired
Product Description:
Please give us as complete a description of your application and product requirements as possible. We would like to know the following: Material requested (EPDM, Nitrile, etc.) and if substitutions are allowed Durometer ranges (between 30 – 95 Shore A) Special requirements (certifications, testing, shipping, etc.) Type of application (Automotive, HVAC, military, etc.)

All fields are required to submit the RFQ.

If you have drawings of your product, please email them to us at info@mid-statesrubber.com and refer to your online request in the Subject line.