M-B Companies: Parts Inquiry Form

M-B Companies, Inc.

Airport Snow Removal Equipment
1200 Park Street
Chilton, WI 53014
Phone: 800-558-5800
Fax: 920-849-2629

Pavement Marking Equipment - Pennsylvania
79 Montgomery Street
Montgomery, PA 17752
Phone: 888-323-2900
Fax: 570-547-1629

Pavement Marking Equipment - Oregon
2490 Ewald Avenue SE
Salem, OR 97302
Phone: 800-253-2909
Fax: 503-370-4389

Attachments Division, Power Broom Brush Replacements and Administration
1615 Wisconsin Ave
P.O. Box 200
New Holstein, WI 53061
Phone: 800-558-5800
Fax: 920-898-4588

Copyright © 2004
M-B Companies, Inc.
All Rights Reserved.
Privacy Statement.

Parts Inquiry Form (This is not a secure form)

Please include your name and contact information . Otherwise, we will be unable to contact you back. BEFORE you submit the form, please complete all asterisk (*) fields.

*Date:

*Parts are required for what piece of equipment? (Model and type of machinery):

*Product ID Tag Information:

*Serial Number:

Other assembly or bill of material number on your ID tag:
(This could be only one, or up to 6 numbers on the ID tag.)

Your Purchase Order Number:

M-B account number, if known:

Parts required:

Item:	Quantity:	M-B Part Number:	1st Description:	2nd Description:
#1
#2
#3
#4
#5
#6

Was a parts book or parts list delivered with your machine?

yes no

If no, and available, would you like one sent with this order?
(NOTE: A printing fee may apply on large books. Contact M-B Service Department.)

yes no

Billing Address

*First Name:

*Last Name:

Title:

Company Name or Agency:

Billing Address:

Street Address:

City:

State or Province:

Country:

Postal Code:

*Phone Number:

Fax Number:

*Email Address:

Shipping Address ( if different than the billing address/ P.O. Box Number not acceptable):

First Name:

Last Name:

Title:

Company Name or Agency:

Street Address:

City:

State or Province:

Country:

Postal Code:

Phone Number:

Fax Number:

Email Address:

Shipping Method

Shipping Method:

Your FEDEX Number or UPS Shipper:

If other, please state:

Payment Method:

Miscellaneous

To establish an open account, please download, complete, and mail or fax in the credit application (PDF format, requires Adobe Reader).

Minimum Order: $50.00 net price.

Your questions are appreciated and will be answered at the earliest opportunity. Please make sure that the above fields are completed so that we may contact you back.