| Type of system needed: Items you want to screen for: (For multiple
selections Hold down Ctrl-key and click on selection)
Type of facility unit will be used at:
Purpose for purchasing:
Your Business Entity Description:
List Entity Type if not listed
above
Check off the types of items you want to screen for:
Narcotics-Cocaine, Heroin, PCP, THC, Methamphetamine, Marijuana, Ecstasy and
others
Explosive substances like Dynamite, HMX, C-4, RDX, PETN, TNT, Semtex, NG and others
Other Contraband not listed here (list below)
Non-Destructive Testing of (food products,
Mfg. Parts, etc)
Chemical Detection- GA, GB, GD, VX, HD,
Lewisite (L), pepper spray, mace
Other Item not listed above -Please list here
Intended place of equipment use:
Budget (approximate):
Time Frame for purchasing:
Please send Quote by: By Fax (email file attachment)
Please follow up withA phone call No phone call E-mail Reply Both email/phone call
Your Company Name:
Address City StateZip
Fax |