REQUEST FOR QUOTATION
================================================================================


FROM:___________________________________________________________________________


DATE:_____________________

--------------------------------------------------------------------------------		
PLEASE QUOTE TO US ON THE FOLLOWING BASIS:


TERMs:     ___FOB    ___C&F    ___CIF    ___Other:______________________________
    
                                                    
SHIP TO PORT:___________________________________________________________________
	
                                                                                                                                                                                      
PAYMENT:   ___Cash in advance  ___Irrevocable letter of credit
           ___COD  (USA port of embarkation only)


SHIPMENTMENT BY:  ___Air       ___Sea Freight    ___Other
     
                                                  
CARRIER PREFERENCE (IF ANY):____________________________________________________
	
                                                                                      
LATEST SHIPPING DATE: __________________________________________________________

	                                                                                       
PACKING: (Standard Seaworth or airworthy export packaging included in price)
If you have any specific packaging request, please indicate here:

                                                                                      

REQUIRED BULB MARKING:  ___NONE REQUIRED    ___"E"    ___"DOT" 

REMARKS:  
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     


 +--------------+--------------+--------------+--------------+--------------+
 |   QUANTITY   |   BULB TYPE  |     VOLTS    |    WATTS     |  BULB BASE   |
 |              | (H7, H4, etc)|              |              |              |
 +--------------+--------------+--------------+--------------+--------------+
 |              |              |              |              |              |
 |              |              |              |              |              |
 +--------------+--------------+--------------+--------------+--------------+
 |              |              |              |              |              |
 |              |              |              |              |              |
 +--------------+--------------+--------------+--------------+--------------+
 |              |              |              |              |              |
 |              |              |              |              |              |
 +--------------+--------------+--------------+--------------+--------------+
 |              |              |              |              |              |
 |              |              |              |              |              |
 +--------------+--------------+--------------+--------------+--------------+
 |              |              |              |              |              |
 |              |              |              |              |              |
 +--------------+--------------+--------------+--------------+--------------+