Step 1 of 3 33% Contact Information Name* First Last Title Company* Address Street Address Address Line 2 City State / Province / Region Zip / Postal Code Afghanistan Albania Algeria American Samoa Andorra Angola Antigua and Barbuda Argentina Armenia Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Central African Republic Chad Chile China Colombia Comoros Congo, Democratic Republic of the Congo, Republic of the Costa Rica Côte d’Ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Fiji Finland France Gabon Gambia Georgia Germany Ghana Greece Greenland Grenada Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati North Korea South Korea Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Mauritania Mauritius Mexico Micronesia Moldova Monaco Mongolia Montenegro Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Zealand Nicaragua Niger Nigeria Norway Northern Mariana Islands Oman Pakistan Palau Palestine Panama Papua New Guinea Paraguay Peru Philippines Poland Portugal Puerto Rico Qatar Romania Russia Rwanda Saint Kitts and Nevis Saint Lucia Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia and Montenegro Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa Spain Sri Lanka Sudan Sudan, South Suriname Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Togo Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam Virgin Islands, British Virgin Islands, U.S. Yemen Zambia Zimbabwe Country Phone Fax Email* Website General Information Manufacturing Location Check if same as above Not Applicable Company Name Address Street Address Address Line 2 City State / Province / Region Zip / Postal Code Afghanistan Albania Algeria American Samoa Andorra Angola Antigua and Barbuda Argentina Armenia Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Central African Republic Chad Chile China Colombia Comoros Congo, Democratic Republic of the Congo, Republic of the Costa Rica Côte d’Ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Fiji Finland France Gabon Gambia Georgia Germany Ghana Greece Greenland Grenada Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati North Korea South Korea Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Mauritania Mauritius Mexico Micronesia Moldova Monaco Mongolia Montenegro Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Zealand Nicaragua Niger Nigeria Norway Northern Mariana Islands Oman Pakistan Palau Palestine Panama Papua New Guinea Paraguay Peru Philippines Poland Portugal Puerto Rico Qatar Romania Russia Rwanda Saint Kitts and Nevis Saint Lucia Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia and Montenegro Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa Spain Sri Lanka Sudan Sudan, South Suriname Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Togo Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam Virgin Islands, British Virgin Islands, U.S. Yemen Zambia Zimbabwe Country Phone Email Referred by: Client Tradeshow Website Partner Other Partner's Company Name Please Briefly Describe Certification Information Please select one of these categories: New Product Quote Quote for a Previously Certified Model Indicate laboratory & customer file number: Please choose the applicable general area family certifications. If specific laboratory marks are required, please check the applicable laboratories: CB Certification UL TUV RNA CSA CE Certification (EU) Safety EMC North America UL CSA ETL TUV RNA FCC/IC Europe National Marks TUV Rheinland China CCC CQC Russia GOST-R Korea KC Mexico NOM South America IRAM Taiwan BSMI Japan VCCI Australia/New Zealand C-Tick Deadline for Certification MM DD YYYY Alternate Listee(s): This is a company that is also listed as having approval to apply the certification mark to the equipment under evaluation. Alternate Listee’s have their own certification report. Multiple Listee(s): This is a company that is also listed as having approval to apply the certification mark to the equipment under evaluation. Multiple Listee’s do not have their own certification report. Product Information Product Type (Name): Product Description: This should contain detail about the unit’s main functions, and how it achieves those functions. This should be a general but technical description. If the job is a revision to a previous job, it should be mentioned here including a description of the changes made to the product. Power Input Rating (V, A): Environmental Rating Indoor only Indoor/Outdoor Model Numbers (separate by commas, 10 max): It is critical to have the correct model numbers in place by the start of the project. These should be obtained as soon as possible. If they are not available at the time of quote, please indicate the number of models that are to be evaluated. Model Difference Description: Approximate Product Weight (lbs): Supplemental Information: Please attach specification brochures and photos of the inside and outside of the product if available. Also overall schematics or block diagrams are helpful. (Max. file size: 5 MB total) File 1 File 2 File 3 Additional Comments / Questions:
RFQ Assistance Need help or have questions about the RFQ process? Please call us at (714) 628-1020 or send an email to info@gmcompliance.com.