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CUSTOMER CONTRACT FORM
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CUSTOMER DATA:

* Required Form Fields

Company: *
Customer ID#:
Address: *
City/State/Zip: *
Telephone: *
Fax: *
Contact Name: *
Email: *
Project:
Method of Payment: *
Work Order P.O.#
Prepayment Check #

SERVICE REQUESTED:

Material Testing: *
Tensile Test
(ASTM A370-05/ASTM E8-04)
Specimen Standardization: * 
By Customer
By CEMCO - according to Procedure
Document ID # 027PTQC01
No. of Samples:
Submittal Date:
Results Issue Date:
Report Delivery:
Regular (10 Days) E-mail
Expedite (2-5 Days) Fax
Rush (24-48 hours) Mail
Please Send Results to: *

Note: Samples could be either dropped off or mailed to the address indicated above.

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