(1) Requests

Today's Date

Quote Number

Please fill in all information in the form below to submit a drawing request:

Are you an authorized RoadWorks® Dealer?*

Yes
No

NOTE:
If "No" you are very welcome to submit a drawing request. RoadWorks® Manufacturing will process your request in the order it is received and will then put you in touch with the RoadWorks® Dealer assigned to process your completed Quote, or the RoadWorks® Dealer of your choice if and when the drawing request is approved by our engineers.

If you have a prefered RoadWorks® Dealer or Chrome Shop you may enter that below.

Do you have a preferred Chrome Shop / Dealer?

Who is your preferred Chrome Shop / Dealer?

Assigned Dealer

Name, Address, etc.

Dealership or Chromeshop name*

RoadWorks® Dealer Number

Name

First Last

Your Location

United States
Canada
Other

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Address

Street Address Address Line 2 City State ZIP Code

Address

Street Address Address Line 2 City Province Postal Code

Phone Number*

Email Address*

Reference / PO#

Vehicle Information

Truck - Model Year

Truck Make

If "Other" please enter truck make here.

Model

Choose your desired product*

If "Other?"

Visor Lighting

Hole Size

Cab Panel Lighting

Hole Size

Cowl Panel Lighting

Hole Size

Sleeper Panel Lighting

Hole Size

Rear Light Bar Lighting

Hole Size

Bumper Options*

Blind Mount
Standard Mount
Box End
Mitered End
Radius Cut to Match Tire
Tow Hole/s
Blank Face

Please Choose Which Your Truck Is Equipped With*

Factory Fenders
Aftermarket Fenders

Describe the custom part that you would like us to produce.

If you have any images or drawings that you would like to submit, please upload here.

Only jpg, gif, png, pdf, dxf, dwg, docx, and doc files are permitted for uploads, and limit 3 at a time please.

Drop files here or

Please click "SUBMIT" send us your drawing request.

Temporary Part Number

Unit

CAD Drawing File Upload Storage

Cost (Holes Only)

Cost (With Options)

Price (Holes Only)

Price (With Options)

Text - Drawing Form Discussion / Notes

Discussion / Conversation with Customer

Reason Lost

Email - Assigned Dealer

Costing Spreadsheet

Dealer User Field

Name

This field is for validation purposes and should be left unchanged.

(1) Requests

Make a Custom Request

Please fill in all information in the form below to submit a drawing request:

Name, Address, etc.

Vehicle Information

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Make a Custom Request

Please fill in all information in the form below to submit a drawing request:

Name, Address, etc.

Vehicle Information

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