Complete, print and enclose with the part you are mailing to:
Lewis Bawol
3308 West 22nd St.,
Erie Pa 16506
COMPANY INFORMATION
Date:
Company Name:
Address:
City:
State:
Zip:
Contact Name:
E-Mail:
Phone:
Ext:
Fax:
WELDING INSTRUCTIONS/SKETCH (use separate sheet if necessary)
Steel Type:
Present
Hardness:
Number of Pieces:
SHIPPING INSTRUCTIONS:
P.O. Number:
Call with estimated price and delivery: { } Yes { } No