CHROMA CORPORATION
3900 Dayton Street
McHenry, IL 60050-8378
Customer Support: (877) 385-8777
Fax: (800) 385-5580 / Check One: (include the Prev. Color # if necessary) / Customer Number: / Quote Number:
= New Match / Market Development
= Cards Only (Prev. Color #) / Bid Package
= Rematch (Prev. Color #) / Optimize Formula / Color Number:
= Value Match
Date Match Received at Chroma: / Color Name:
CUSTOMER: / Customer Code:
Co. Name / Final Application
Address / Indoor Use / Outdoor Use
End User
City, ST Zip / Target
Phone: / Fax: / Date Submitted: / Date Required:
Contact: / E-mail: / Rep: / Submitted By:
CUSTOMER RESIN / REGULATORY INFORMATION / MATCH TOLERANCE
Resin Type / FDA/EU Indirect Food Contact / House Wares / Critical
Supplier / Toys / DE< CMC CieLab
Designation / Heavy Metal Free / CONEG / Good Visual
Other (Heavy Metal OK) / RoHS/WEEE / Non-Critical
Melt Flow / Density / MMP/Medical / Body Fluid Contact? / Matching Parts – Number :
Commercial and/or Non-Critical: Use house resin for color matching and QC. / Class I / Class II / Class III / Class IV
Critical and/or Engineering Resins: Sending minimum of 20 pounds per color match. Include additional resin for QC purposes (please attach resin spec. sheet). / THERMAL STABILITY / Additional Production Tolerance
Conventional Tooling / Temp. / Comments:
Hot Runner Mold / Oven Temp.
Rotational Molding
Bucket # / Will concentrate be dried with resin? / Yes / No
PART DECORATION / CUSTOMER PROCESS / SURFACE/LIGHT / ADDITIVES
Silk Screen / Injection Molding / Per Sample / U.V. / % / PART THICKNESS
Pad Print / Sheet/Profile Ext. / Matte / Antioxidant / % / Opaque
Laser Marking / Blown/Cast Film Ext. / High Gloss / Antistat / % / Translucent
Hot Stamp / Blow Molding / Textured / Slip Agent / % / Transparent
Dry Offset / Rotational Molding / CWF / Antiblock / % / Press Out @
Other / Other: / Daylight / Other / % / Comments
Other
QUOTE REQUIREMENTS / PRESENT METHOD / DESIRED PRODUCT
Submit: / Number of Color Chips / Return Target / Concentrate @
Injection Chip: / Flat / 3-Step / 4-Step / Concentrate @ / Best LDR
Roto Chip: / Disc / Block / Other Requirements / Dry Color / Not to Exceed
Precolor / Dry Color / lb/units
Liquid @ / Dry Color Bulk
Letters: / MSDS / FDA / CONEG / Medical / Comments: / Precolor – Resin Supplied by:
E.U. / Prop 65 / Chroma / Customer
Management Review / Sample: / Yes / No / Qty / Salt & Pepper Blend
Special Shipping: / UPS/Fed ExAcct. # / Remarks:
Quantity Requirements / Pricing Information
Request for ballpark price (no match required) / Current Supplier of this:
Quantities to be Quoted: / Existing price & quantity:
Annual Volume: / Minimum Order:
Match/Make Order / Qty: / Lot #: / Existing freight terms:
PO# / Chip approval before order / Yes / No / Reason for changing:
Special Instructions:
LABORATORY USE ONLY / COLOR NAME: / COLOR NUMBER:
Match Resin:
Bucket #: / Remaining Resin:
Code / Material I.D.
TYPE OF SHOT / Final Formula / C / V / C / V / C / V / C / V / C / V / C / V / C / V / C / V / C / V / C / V
Code / Material I.D. / 1 / 2 / 3 / 4 / 5 / 6 / 7 / 8 / 9 / 10
Color Matcher Initials
PRODUCTION MIXING INSTRUCTIONS / LDR / /1 / Use Rate: / Q.C. Material:
______
Masterbatch: Welex Bag Shake / QC TESTS: / TARGET / RANGE / Matching Parts
Color Number: ______
Feedstock: Welex
Feedstock: Mixaco / Melt Index: / To Tolerance Set / To Master File Chip
Feedstock: Drum Tumble / PelletCount: / Stored Std: / Other
Dry Color: Welex / Ash Content:
UNDERWATER PELLET: / Color Difference: / CMC / CIEL*a*b / Cards Only: QC To: ______
Minimum Order Size: / Color Tolerance: / DE / Q.C. Instructions:
TWIN OR FCM: / By: / DL* / Da* / Db*
Other:
Feeder Blend Use Rate: /
PRODUCTION COMMENTS
GRIND SPECIFICATION:Standard Roto / 35 Mesh
Granite Mesh / 12 16 20 35
TO BE FILLED OUT BY COLOR MATCHER:
Color Code: / ______- ______ / Molding Machine # ______/ Film Line ______/ Hot Plate ______
Color Labels: / RL / YL / RY / WL / Zone 1 ______F / Zone 2 ______F / Zone3 ______F / Die/Nozzle ____ F
Back Pressure / ______/ Screw Speed / ______
FDA / CONEG/RoHS / HMF / Mixing Equipment: / ______/ Time / ______
XMP / MMP / Cadmium / Lead / Formulator: / ______/ Date / ______
Disclaimers: / R/M Test Price: / ______/ Date / ______
Trans: / Fluor: / Pearl/Met: / Glass: / Color Technician: / ______/ Date / ______
Other: / Critiqued By: / ______/ Date / ______
Formula Entry: ______/ Date: ______/ Process Engineer: / ______/ Date / ______
Revised 9/4/08– JVB CF 04001