PAMI Harness Questionnaire

HARNESS QUESTIONNAIRE

Please fill out the following form to the best of your knowledge. The information provided will remain strictly confidential. Our Electronics Lab and Cable Shop team are looking forward to working with you. If you have any questions, please don't hesitate to reach out at 1-800-567-7264.
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
What general industry does your business represent? (This information helps to organize our workflow and streamline our staff.)
Number of Connectors Required:
Part Numbers for each Required Connector: (please generate list)
Number of Wires/Cables Required:
Part Numbers for each Wire/Cable - Include AWG and colour if applicable: (please generate list)
Harness Overall Dimensions: Length (LENGTH) Width (WIDTH)
Do you need Harness Protection Covers?

YESNO
If 'YES', choose:

Braided Yarn (recommended)Braided LoomHeat ShrinkPlastic TubeOther
If 'Other', please indicate part number:
Labels Needed?

YESNO
Total Quantity of Harnesses?
Desired Harness Completion Date

MonthDayYear
Please upload the following supporting documents to help our team better support your request. Any information you can provide will help.
1. Computer or hand drawn harness layout with dimensions (1:1 layout is not necessary, but all runs, branches, splices, etc need to have measurements)
2. Bill of materials
3. Pinout diagram or list
4. Any other supporting documents (wire labels, connector labels, schematics, etc)
File Upload

Cancelof
Did we miss anything? Notes/Requests/Additional Information/Other Specifications:
Should be Empty:

HARNESS QUESTIONNAIRE