CUSTOMER INFORMATION

Company

Legal Billing Entity Name

Name

Phone

Preferred Contact Method*

SERVICE INFORMATION

BHD Lab Location*

Type Of Service*

Quote#

Address

Street Address City Province Postal Code

PO#

Payment Method

Address

Same as Billing

Street Address City Province Postal Code

Courier

Courier Account #

Courier Service Type

Types Of Equipment

Quantity

Manufacturer

Model

Serial#

Service Required

Comments

Calibration Type

Calibration Interval

ELECTRICAL ENGINEERING SERVICES

ELECTRICAL FIELD TESTING SERVICES

INFRARED & CORONA ELECTRICAL SCANNING

ELECTRICAL & SAFETY PRODUCTS

Safety

POWER CABLE TERMINATION AND TESTING