Please print, fill in and fax back to:

Liebherr Gear Technology Co., Saline, MI.

Quotation required by (date): __________________

Company ___________________________________
Address ____________________________________
City _______________________________________
State Zip ___________________________________
Contact ____________________________________
Title _______________________________________
E-mail _____________________________________
Telephone __________________________________
Fax _______________________________________

Check for a representative of Liebherr Gear Technology to contact you

Process: Hobbing Shaping Shaving Grinding Other
Automation: Manual Load Auto Load

Maximum Pitch: ________ or Module:________
Maximum Outside Diameter: _______________
Maximum Face Width: ____________________

Please note any special requirements or tolerances:

__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________