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Job Quote Submittal Form

For quantity prices on any of our fluorescent fixtures, please fill out all the information below and we will get back to you either by phone or email promptly - usually within just a few hours.

Your Name:

Company Name:

Email Address:

Address:

City:

State:

Zip:

Enter Item Number(s) and Quantity:


Additional comments:

 
   
 
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Brodwax Lighting Corporation • 1333 SW 30th Ave • Deerfield Beach • FL 33442
Phone: 800-841-4666 • Fax: 954-360-7449 • info@brodwax.com