Order Form - Turboship 7 & 10 Line Parts - Sargent Locks

®CUSTOMER ORDER NO.THIS FORM IS THE PURCHASE ORDER.DO NOT SEND A COVER P.O.DUPLICATED ORDERS CANNOT BERETURNEDORDER FAX (800) 906-6606DATEOrder Form - TurboshipDoor Closer & OverheadHolder & Stop PartsPlease Specify Program RequiredOne Program per Order FormCUSTOMERADDRESSTurbo - 24-HourExpress ProgramInvoiced at Book NetOrders Ship within 24-HoursCITY STATE ZIPBUYERTITLESHIP GOODS TO1 Week – TurboBuying Program %Orders Ship within 5 Working Daysby®ADDRESSATTN TO:CITY STATE ZIP3 Week - Contract ExpressStandard Buying Program %OR QUOTE #Orders Ship within 15 Working DaysORDER ID:SHIP VIA: STD. SARGENT CARRIER (OTHER)FOR EDITING, DO NOT WRITEORD NO.Note: Use 1 Order Form per Buying Program (24-Hour, 1 Weekor 3 Week Contract) based on the availability of the productOrdering Form: Door Closer AccessoriesQtyCatalog/Part #Door Closer Parts - DescriptionFinishes Available for24-Hour ExpressAvailabilityFinishes Availablefor 1Wk & 3WkSpecify Finish125P9 Parallel Arm Foot – EB, EN, EAB125PH9 Parallel Arm Foot – EB, EN, EAB125 P3 Arm Conversion Unit EB, EN EB, EN, EAB, EP125 P3A Arm Conversion Unit EB, EN EB, EN, EAB, EP125P4 Arm Conversion – EB, EN, EAB, EP125 P4A Arm Conversion Unit EB, EN EB, EN, EAB, EP351A Mounting Plate EB, EN EB, EN, EAB, EP351B Mounting Plate EB, EN EB, EN, EAB, EP351D Drop Bracket EB, EN EB, EN, EAB, EP1431D Drop Bracket EB, EN EB, EN, EAB, EP281D Mounting Plate — EB, EN, EAB, EP© SARGENT Manufacturing Company 2007 All rights reserved581-1 Blade Stop Spacer Kit (P9, PH9, PF9) — EB, EN, EAB, EP581-2Blade Stop Spacer Kit(P10, PS, PSH, CPS, CPSH, PH10)— EB, EN, EAB, EP4TB Through-Bolt Pack EB, EN EB, EN, EAB, EPPaint Paint (One Color per 12 Unit Case) — EB, EN, EAB, ED, EPNote: (–) mean the Product or Part is not available in the buying ProgramQtyMS5Catalog/Part #Accessories DescriptionFinishes Available for1 Wk. & 3 Wk.21-0198 1540 Jamb Bracket Shim 26D01-3436 Machine Screw 26D21-0104 590 Jamb Bracket Shim 26D01-3454 Machine Screw 26D