Order Form - Sargent Locks

THIS FORM IS THE PURCHASE ORDER.DO NOT SEND A COVER P.O.DUPLICATED ORDERS CANNOT BERETURNEDORDER FAX (800) 906-6606Order Form - ElectroTURBOElectro-Mechanical Parts& AccessoriesCUSTOMER ORDER NO.CUSTOMERADDRESSDATEElectroTURBO - 24-HourExpress ProgramInvoiced at Book NetOrders Ship within 24-HoursCITY STATE ZIPBUYERTITLE1 Week – ElectroTURBOBuying Program %Orders Ship within 5 Working DaysSHIP GOODS TOADDRESSATTN TO:CITY STATE ZIPORDER ID:SHIP VIA: STD. SARGENT CARRIER (OTHER)3 Week - Contract ExpressStandard Buying Program %OR QUOTE #Orders Ship within 15 Working DaysFOR EDITING, DO NOT WRITEORD NO.Ordering Form: Electro-Mechanical Parts & AccessoriesAvailabilityQtyCatalog/Part #Description24-HourElectroTURBO1 Week ElectroTURBO &3 Week Contract ExpressFinishSwitches, Keypads, Key Switches & Readers4341 Momentary Push Button – Yes 32D4291 Keypad - Indoor – Yes 32D4292 Keypad - Outdoor – Yes 32D4301 Card Reader – Yes *4370 One SPDT Maintain Key Switch – Yes 32D4371LTOne SPDT, w/2 LED’s & Adjustable Time,Momentary Key Switch– Yes 32D4375LH Two SPDT, 2 LED’S, 1 Horn, Momentary Key Switch – Yes 32D55- Request to Exit Insert Kits855-1 ”F” Wide Insert & Switch Assembly Yes Yes 32D855-2 ”F” & ”E” Narrow Insert & Switch Assembly Yes Yes 32D855-3 ”G” Wide & 8895E Insert Switch Assembly – Yes 32D855-4 ”G” Narrow & 8895F Insert Switch Assembly Yes Yes 32D855-5 ”E” Wide Insert Switch Assembly – Yes 32D855-6 ”J” Narrow Insert Switch Assembly – Yes 32D855-7 ”J” Wide Insert Switch Assembly – Yes 32D855-8 8895J & 8895G Wide Insert Switch Assembly – Yes 32DNote: (–) Product or Part is not available in the Buying ProgramNote: (*) or "Standard" means product is available and finish is not specifiedEM205/01/09 90661:C Copyright © 2007-2009, Sargent Manufacturing Company, an ASSA ABLOY Group company. All rights reserved.Reproduction in whole or in part without the express written permission of SARGENT Manufacturing is prohibited.