EmailMe Form - Southwell Plaque Quote

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<p><b><font size="4" face="Arial">CAST PLAQUE/HISTORICAL
MARKER <br>
QUOTATION FORM</font></b> </p>
<p><font size="2">All fields marked with a (*) is required
</font> </p>
</div>
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<td bgcolor="#000099"><img name="home_r8_c30" src="http://www.southwellco.com/images/home_r8_c30.gif" width="18" height="115" border="0"></td>
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Bill To - Company/Name: (*) *

Contact:(*) *

Address:(*) *

City(*) *

State(*) *

ZIP:(*) *

Phone:(*) *

Email:(*) *

Fax:

Ship To:

Same as Bill To address

Company/Name:

Contact:

Address:

City:

ZIP

State

Fax:

Do you need delivery by a specific date?(*) *

If Yes When?

Are you willing to pay RUSH charges?

Quantity Required(*) *

Material:

Aluminum

Bronze

Background Color

Black (Normally for aluminum plaques)

Oxidized/Dark Brown (Normally for bronze plaques)

Other (Requires sending a physical sample for paint matching)

Size W inches (Normal Plaques)

Size H inches (Normal Plaques)

Inces Diameter (for circular plaques)

Border

Single Line

Double Line

Plain Bevel

Single Line Bevel

Projected Bevel

Moderne (borderless)

Letter Styles:

Times New Roman

Helvetica

Futura

Other

Mounting

Concealed

Post Mounting

Rosettes with Toggle Bolts

Expansion shields

Wood Screws

I have a logo I would like to use

YES

Upload logo

Logo Portrait (if applicable)

2-Dimensional(flat)

Sculptured

Multi-Colored Logo? If so how many colors?

Text for plaque or marker:(*) *

Image Verification
	Please enter the text from the image: [Refresh Image] [What's This?]

<p align="center"><font size="2">All orders are
F.O.B. Factory and will have freight added at time
of shipment.</font><br>
</p>
</form>
<p align="center"><font size="2">You may also fax,
mail, or <a href="mailto:sales@southwellco.com">email</a>
us your text, see information below.</font>
<p align="center"> </td>
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<td valign="top">
<div align="left"><img src="/btm_left_spacer.gif" width="126" height="1"><br>
<b><font size="2" face="Arial, Helvetica, sans-serif"><a href="http://www.southwellco.com/castplaques.html">Cast
Plaques</a><br>
<a href="http://www.southwellco.com/historical.html">Historical
Markers</a><br>
<a href="http://www.southwellco.com/metalletters.html">Metal
Letters</a><br>
<a href="http://www.southwellco.com/customsignage.htm">Custom
Signs</a></font></b> </div>
</td>
<td>
<table border="0" cellpadding="0" cellspacing="0" width="240">
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<td><img name="home_r11_c10" src="http://www.southwellco.com/images/home_r11_c10.gif" width="240" height="13" border="0"></td>
</tr>
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<td><img name="home_r12_c10" src="http://www.southwellco.com/images/home_r12_c10.gif" width="240" height="36" border="0"></td>
</tr>
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<td><a href="http://southwellco.com"><img name="home_r13_c10" src="http://www.southwellco.com/images/home_r13_c10.gif" width="240" height="19" border="0"></a></td>
</tr>
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</td>
<td valign="top">
<div align="right"><img src="/btm_right_spacer.gif" width="113" height="1"><br>
<b><font size="2" face="Arial, Helvetica, sans-serif"><a href="http://www.southwellco.com/military.htm">Military
Logos</a><br>
<a href="http://www.southwellco.com/adasign.htm">ADA Signs</a><br>
<a href="http://www.southwellco.com/metalletters.html">Metal
Letters</a><br>
<a href="http://www.southwellco.com/superstamps.html">Super
Stamps</a></font></b></div>
</td>
<td><img name="home_r11_c27" src="http://www.southwellco.com/images/home_r11_c27.gif" width="58" height="68" border="0"></td>
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