Request For Quotation

A quote for services is typically provided within three to five business days after receiving the written requirements. Quote requirements may be communicated to LebenTech via mail, fax 954-323-4784, email lennox.bennett@lebentech.com, or through this website. To minimize delay and confusion, it is very helpful if the following information is provided:

NOTE: Instructions for sending file attachments [i.e., specifications, special instructions, photos, drawings, etc.], are given after sending this form.p

"*" indicates required fields

Requestor

Organization:*

Division:

Shipping Address:*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Point of Contact

Name:*

First Last

Title:

Email:*

Phone:*

Fax:

General Quote Information

Type of Quote Needed:

Hourly Rate

Consulting Charge

Special Needs:

None

Recommendations

Graphical Representation

Statistical Analysis

Expected date for the start of Assignment:

MM slash DD slash YYYY

NOTE: LebenTech prefers to have a purchase order at least five days prior to the start of an assignment to allow for proper contract review, planning and engineer selection.

Assignment name, Project, or Product Model:

Length:

Responsibility:

Support Engineers:

Additional Information:

Product / Process Requirements

Requirements:

To Be Sent

Listed Below [ Specification, Deliverables ]

Requirement List:

Data Documentation Requirements

Requirements

Report with Data

Engineering Analysis

Raw Data Only

None

NOTE: LebenTech reports attest to the data associated with the evaluated engineering problem, and represents the output of the engineering assessment and evaluation with special details associated with customer's deliverables requirements.

Data Documentation Media Preference:

Adobe PDF

MS Word [protected]

Data Documentation Delivery Preference:

Email

CD

Hard Copy

NOTE: Additional charges may apply for CD and Hard Copy deliveries.