Metal-Free Anti-Seize QUICK QUOTE REQUEST FORM NAME DATE COMPANY ADDRESS TEL. NO.   FAX NO.     E-MAIL ADDRESS      TAXABLE       RESALE       F.O.B. POINT       SHIPPING PREPAID       COLLECT    STOCK NO. DESCRIPTION QTY COMMENTS/QUESTIONS For further information, call or fax: Depac Products US, Inc. 7406 27th Street West Suite 10 Tacoma, WA 98466 Tel. No. 253-565-6833 | Fax No. 253-564-1886 E-mail fickassoc@hotmail.com Also, call or fax for local representative or distributor in your area. © 2000 DEPAC PRODUCTS INC., ALL RIGHTS RESERVED