Extrusion Die / Bushing Quote Worksheet

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Company Name:

Contact Name:

Street Address:

City: State: Zip:

Contact Phone: Contact Email:

...................................................................................................................................................................

Please provide the following information so we can
determine the extrusion tooling that best suits your needs.

Extrusion Head Make:

Extrusion Head Model:

Note: If not a standard B&H head
please email reference print.

Material:
420 Stainless Steel
C-276 Hastelloy
Other (Specify)

Choose Style:
Refer to DIE STANDARD DRAWING
Style A
Style B
Other (Specify)

Application:
What type of product will this die be used to make?
Pressure
Jacketing / Sleeving
Tube Extrusion
Other (Specify)

Compound:
What material will be used to create end product?

Dimensions (please specify separately if more than one size required):
Refer to DIE DRAWING STYLE A OR B

ID (B):

Land (L):

OD (X):

Overall Length (Y):

Specify quantities requested and any special instructions: