Requestor
Organization * :
Division:
Shipping address * :
City, State, Zip * :
Point of Contact
Contact name & title * :
Email address * :
Phone number * :
Ext:
Fax number:
General Quote Information
Type of quote needed :
Budgetary
Firm Fixed Price
Special needs :
None
A2LA
ISTA
Expanded Uncertainty
NOTE:
Qualtest takes exception to providing Expanded Uncertainty, even when
required by the test standard, unless special arrangements are negotiated in
advance.
Expected date for the start of testing:
NOTE: Qualtest prefers to have a purchase order at least five days prior to
the start of a test to allow for proper contract review, planning and test
preparation.
NOTE: With regard to support equipment supplied by the customer, Qualtest
assumes responsibility only for equipment needed to satisfy our contract
obligations. Any additional equipment brought by the customer is the
responsibility of the customer.
Expected number of onsite
customer reps/witnesses:
Note: Qualtest offers a customer lounge area equipped with phone, cable TV,
High Speed Internet access, vending machines and free coffee. Copier and fax
machines are readily available. Dial up modem connection can be arranged.
Test Item
Identification
Name, P/N, or Model * :
Weight * :
Size(LxWxH) * :
Quantity * :
Any Additional Descriptive Information
(HAZMAT, Fragility, Storage, External Ground Connections, RF Transmit
Device, End Item Platform, etc.):
Test Requirements:
Test Requirements * :
attached
listed below
(Test Type, Test Spec, # Test Items, Field Levels, Modulation, etc.)
Test Item Support Requirements
How will the test items interface?
(Distance of cable from test item to support equipment (6 foot minimum
required)
NA
Customer provided fixture
Qualtest provided Stand-offs and Strap-downs
Additional Interface Information:
What are your
Ground Plane
Requirements?
NA
Customer Provided
Conductive Table
Non-Conductive Table
Additional Information:
Electrical / Mechanical needs for Test Item Operation
(power / phase / frequency; gas pressure; connectors, etc):
NA
Described Below
Responsibility for Test Item Operation:
NA
Customer Rep.
Qualtest (requires detailed procedure for quote)
Additional information:
Data Documentation Requirements:
Report with data
Certification without data
Raw data only
None
NOTE: Qualtest Reports and Certifications attest to the compliant
provision of the test environment, but not to the pass/fail status of the
test hardware unless special arrangements are negotiated in advance.
Data Documentation Media
Preference:
Adobe PDF
MS Word (protected)
Data Documentation Delivery Preference:
Email
CD
Hard
Copy
NOTE: Additional charges apply for CD and Hard Copy deliveries.
Any special needs, comments, or concerns:
Quote Need / Desired Date