ORDER FORM – Culvers Chain Specific

PROJECT NAME

INSTALL STREET ADDRESS

STORE NUMBER (IF KNOWN)

INSTALL CITY

OVERALL FRAME SIZE

47.5”w x 43.5”h (48”w x 44”h rough opening)

CHOOSE CONFIGURATION

Most of US – model 600 with ¾” insulated tempered glazing

Hurricane IMPACT zones – model 600 with ¾” smash & grab glazing Florida Product Approval Florida Building Code Online

Bullet Resistant – model 600 with ¾” Level 1 BR lexan

FRAME COLOR

Clear Anodized

MODE OF OPERATION

SC - Manual Open / Self Close by Gravity (no power required)

OPENING DIRECTION FROM OUTSIDE VIEW

Left to Right from outside view (Culvers Standard)

Right to Left from outside view

Multiples (explain in COMMENTS)

ACCESSORIES

RAC-22 Heated Inside Mount Low-Profile Window Air Curtain (includes 46”w mounting kit/switch package)

RAC-22 Unheated Inside Mount Low-Profile Window Air Curtain (includes 46”w mounting kit/switch package)

Not needed

COMMENTS

PO NUMBER

QUOTED PRICE

(An email confirming the price & payment
details will be sent prior to fully processing)

PAYMENT TERMS

Credit Card

Net 30 (Pending Approval)

CIA - Cash in Advance

COMPANY NAME

YOUR NAME

PHONE NUMBER

BILL TO ADDRESS

CITY

STATE

ZIP

SHIPPING INFORMATION

SAME AS BILL TO

Yes

COMPANY NAME

FREIGHT TERMS

Collect - Freight cost not included in total price. Pay carrier for freight at time of delivery for best rate.

Prepay & Add - Freight cost included in total price. Special Handling added at time of delivery will be automatically billed to the same method of payment (ex: reconsignment, residential address, liftgate, etc)

SPECIAL HANDLING

24 HR Pre-call ($30)

Liftgate ($165)

Inside Delivery ($175)

Residential ($125)

Construction Site ($125)

*estimated special delivery charges in addition to LTL freight—price may vary. Special Handling added at time of delivery vs on this order form will be automatically billed to the same method of payment for Prepaid & Add shipments.

ADDRESS

CITY

STATE

ZIP

ACKNOWLEDGE

I hereby acknowledge all information is correct and would like to proceed with the above order as described. By submitting you agree to our general terms.

PLEASE BE ADVISED

Opening direction is always from outside view.
Lead times vary depending on options that are chosen and will be sent with your quote. These are subject to change at any time.
Restocking fee is 25% + Damages + Freight and must be approved prior to sending back.
SUBMITTAL information including electrical requirements, cut sheets, installation manuals, and more are available under the product page DOWNLOADS tab.

ORDER FORM – Culvers Chain Specific

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BILLING INFORMATION

SHIPPING INFORMATION

PLEASE BE ADVISED