FAST-FAX ORDER/REQUEST FOR QUOTE WARFIELD ELECTRIC COMPANY, INC. FAX: 815/469-4168 • FAX 800/256/3384 • e-mail: nancy@warfieldelectric.com (THIS ORDER FORM CAN BE SENT ONLINE OR PRINTED OUT AND FAXED) Fields marked with '*' are required fields. HERE IS MY QUOTE MY ORDER NO: DATE: mm/dd/yy QUOTE PRICE AND AVAILABILITY MY FAX NUMBER IS: MY NAME OR COMPANY: * MY EMAIL ADDRESS IS: * BILL TO: SHIP TO: SHIP VIA: UPS UPS RED EMERY UPS BLUE OTHER: IN THIS BOX, PUT THE FOLLOWING INFORMATION: QUAN/PART NUMBER/DESCRIPTION/PRICE EA./AVAILABILITY USE VISA/MC (ONLY IF PRINTING AND FAXING!): NO: EXP DATE: BILL ME REQUESTED BY: Back to the top.   About Us | Products | Service & Repair | Online Services | Links | Contact & Locations For New motors, Visit WEMOCO.