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Please complete this form and click on the send button at the bottom. Any information you provide to us will be kept confidential - meaning we will not resell, share, lend or give any of the following information you provide to us to any organization or person outside of our company. *All Fields Are Required.


Your Information:
First Name:   Last Name:
Company Name:   Job Title:
Department:   Street Address:
City:   State:
Zip Code:
Business Phone #:   Cell #:
Fax #:   Email:

Package Information:
Package Name or Model Number:
Package Size (inches): Length: Width: Height:
Gross Weight as Shipped (lbs.): Pre-Inspection: Y N / Post-Inspection: Y N

I Would Like to Receive a Quote on the Following:
  Package Testing
     Condition     Distribution

Product Testing

Material Testing
     Condition      Distribution

Medical Testing

UN/DOT Testing
     Condition      Distribution

Additional Comments:
 

Please include what kind of testing you are interested in (ASTM, ISTA, ISO, MIL, or NMFC) and if you know what procedure, please include as well. Purple Diamond may need to call for more information if needed to provide the most detailed quote possible. Thank you.