Barnes Quote/Information Request Form
 

All information entered here will stay within Barnes and is for our own use.

Fields marked with * are required

 

Your Name

*

Job Title

*

Company

*

Address

*

City

*

State/Province

*

Postal Code

*

Country

*

Phone

*

Fax

*

Email

* Be sure to include a correct email address, for example: someone@sample.com

Would you like

*

Quote on screw assembly:

 

 

 

Check items to be quoted

 

 

 

New Ball Screw

 

Reconditioned Ball Screw

Reloaded Ball Screw

 

Emergency Repair

New Acme Screw

 

Reconditioned Acme Screw

Acme Retrofit to Ball Screw

 

 

** These fields required only if quote is requested

Outside Diameter

**

Overall Length

**

Lead

**

Machine Mfg.

**

Machine Model No.

**

Machine Mfg. Part No.

**

Axis

**

 

 

Comments or special instructions