| Name: * |
|
| Company: * |
|
| Address 1: |
|
| Address 2: |
|
| City: |
|
| State/Province: |
|
| Zip: |
|
| Country: |
|
| Phone: * |
|
| Fax: |
|
| Email: * |
|
| |
|
| Cord Sets |
|
| Types: |
|
| Right Angle Ground Pin: |
|
| 2 Conductor Blade Type: |
|
| Length: |
|
| Removal of Outer Jacket (ROJ): |
|
| Color: |
Other:
|
| Wire Type: |
Other:
|
| AWG Type: |
Other:
|
| NEMA Type: |
|
Termination
Appliance End: |
Other:
|
| |
|
| Extension Cords |
|
| Plug Type: |
|
| AWG: |
|
| Length: |
|
| Color: |
Other:
|
| |
|
| International Cord Sets |
|
| Types: |
|
| AMP Fuse (UK only): |
|
| Colors: |
|
| Length: |
|
| Removal of Outer Jacket (ROJ): |
|
| |
|
| Application/Comments: |
Please provide a brief description of your application
and any other comments:
|
|
|
|