877-345-4387

Fields marked with an * are required.

Primary Contact:
*Name:			*Order Date:
*Office Phone:			Purchase Order #:
Mobile Phone:			Job Name:
*E-Mail:			Dealer#:


Bill To:			same as billing Ship To:
*Company:			*Company:
*Address:			*Address:

*City:			*City:
*State:			*State:
*Zip			*Zip
*Phone:			*Phone:
Fax:			Fax:
*E-Mail:

Distance from controller to main junction box
(for lead length out of controller)
5' standard leads, add $10 per foot after 5'.

Gate & Switch Application

*Conduit Required in Hoist-Way: Not Required Required
*Commercial Application GAL Interlocks: Not Required Required
*Quantity	*Cab Material	*Size

Custom Dimensions*: W: D: H:
*Birch cabs measured by outside dimensions, max height 36", max depth 29-1/2"

500 lb dumbwaiter motor requirements: 230 Volt Single Phase 230 Volt Three Phase

*Motor Location: Bottom Floor Overhead Top Floor

*#Stops	*Configuration

Finished Floor to Floor Dimensions:
*1-2 =	inches*
2-3 =	inches*
3-4 =	inches*

*Hall Stations:

*Doors:

*Quantity of Doors:

WALL THICKNESS:

(example 4-1/2")

Select Your Door Swing and Door Location For Each Level:
*Level 1	*Level 2
Level 3	Level 4

Comments/Notes:

ORDER CONFIRMATION - You will receive an invoice from our billing department within 24 hours of placing your order (Mon-Fri). If you do not receive an invoice in this time please contact us for order confirmation and thank you.

Primary Contact:

Bill To:

Ship To:

Finished Floor to Floor Dimensions:

*Hall Stations:

*Doors:

*Quantity of Doors:

WALL THICKNESS:

Select Your Door Swing and Door Location For Each Level:

*Level 1

*Level 2

Level 3

Level 4

Comments/Notes: