Request Information

<body topmargin=0 leftmargin=0 marginheight=0 marginwidth=0> <table cellpadding=0 cellspacing=0 border=0><tr> <td valign="top" colspan=2 height=80 BGCOLOR="#000000" TEXT="#F7F7FF" bgproperties="fixed" background="03c00500dvldtc.gif"> <div> <FONT SIZE="6" COLOR="#FFCC66" FACE="Times New Roman" >                           </FONT><B>C</B><FONT SIZE="6" COLOR="#FFCC66" FACE="Times New Roman" >and</FONT><B>R</B><FONT SIZE="6" COLOR="#FFCC66" FACE="Times New Roman" >equipment</FONT>.<FONT SIZE="6" COLOR="#CC9900" FACE="Times New Roman" >com</FONT><FONT SIZE="7" COLOR="#FFCC66" FACE="Times New Roman" > </FONT></div> <div>  <FONT SIZE="3" COLOR="#CC9900" FACE="Arial" > </FONT><FONT SIZE="4" COLOR="#CC9900" FACE="Arial" >    </FONT></div> </td> </tr><tr> <td valign="top" width=210 BGCOLOR="#000000" TEXT="#F7F7FF" background="03dd2c00dvldtc.gif"> <div> <A HREF="index.html" TARGET="_top" TITLE="MINING EQUIPMENT CR Equipment Sales is "><U>Home</U></A></div> <div> <A HREF="id2.htm" TARGET="_top" TITLE="About Us"><U>About Us</U></A></div> <div> <A HREF="id104.htm" TARGET="_top" TITLE="Contact Us"><U>Contact Us</U></A></div> <div> <A HREF="database.htm" TARGET="_top" TITLE="Mining Equipment Database"><U>Mining Equipment Database</U></A></div> <div> Request Information</div> <div> <A HREF="featuredequipment.htm" TARGET="_top" TITLE="Featured Equipment"><U>Featured Equipment</U></A></div> </td> <td valign="top" height=400 BGCOLOR="#000000" TEXT="#F7F7FF"> <div> Request Information</div> <div>      To request more information or a quote on equipment, or if you need equipment that is not featured on our website,  just fill out the request form below with specific details regarding the equipment you need, <FONT SIZE="4" COLOR="#CC9900" FACE="Times New Roman" >(</FONT> including the stock number<FONT SIZE="4" COLOR="#CC9900" FACE="Times New Roman" >) </FONT>& we will respond to your request within 48 hours.</div> <bR> <div>      Thank you for giving us the opportunity to serve you !</div> <bR> <bR> <bR> <div>                           <form action="http://formmail.trellix.com/servlets/TlxMailer" method="POST" enctype="application/x-www-form-urlencoded"><input type="hidden" name="tlx_SortOrder" value="First & Last Name,Company, Title,Email,City,State,Phone,Fax,Type of equipment,Make & Model,Stock Number,equipment search,Comments,Priority"><input type="hidden" name="tlx_FormIndex" value="2"><input type="hidden" name="tlx_OKMessage" value="Thank you for your inquiry.we will respond to your request within 24hours"><input type="hidden" name="tlx_SendMode" value="1"><input type="hidden" name="tlx_Subject" value="A request form was submitted"><input type="hidden" name="tlx_EmailTo" value="sales@candrequipment.com"> <table cellpadding="0" cellspacing="1" border="0" align="center"> <tr> <td align="left">First & Last Name:<br> <input type="text" name="First & Last Name" size="40" maxlength="100"></td> </tr> <tr> <td align="left">Company Name:<br> <input type="text" name="Company" size="40" maxlength="100"></td> </tr> <tr> <td align="left"> Title:<br> <input type="text" name=" Title" size="20" maxlength="100"></td> </tr> <tr> <td align="left">Email:<br> <input type="text" name="Email" size="30" maxlength="100"></td> </tr> <tr> <td align="left">City:<br> <input type="text" name="City" size="30" maxlength="100"></td> </tr> <tr> <td align="left">State:<br> <input type="text" name="State" size="15" maxlength="100"></td> </tr> <tr> <td align="left">Phone Number:<br> <input type="text" name="Phone" size="15" maxlength="30"></td> </tr> <tr> <td align="left">Fax Number:<br> <input type="text" name="Fax" size="15" maxlength="30"></td> </tr> <tr> <td align="left">Type of equipment:<br> <input type="text" name="Type of equipment" size="30" maxlength="150"></td> </tr> <tr> <td align="left">Make & Model:<br> <input type="text" name="Make & Model" size="40" maxlength="10"></td> </tr> <tr> <td align="left">Stock Number:<br> <input type="text" name="Stock Number" size="15" maxlength="100"></td> </tr> <tr> <td> <input type="checkbox" name="equipment search" value="yes"> Equipment needed was not found on website, Please search & locate.</td> </tr> <tr> <td align="left">List specifications for needed equipment / comments:<br> <textarea name="Comments" rows="12" cols="55"></textarea></td> </tr> <tr> <td align="left">Priority:<br> <input type="text" name="Priority" size="15" maxlength="100"></td> </tr> <tr> <td align="right"><input type="reset"> <input type="submit" value="Send" name="tlx_send"></td> </tr> </table> </form>  </div> </td> </tr></table></body>