Bill to:

          Name:
  Organization:
       Address:
               
          City:  State/Province:
   Postal Code:
       Country:
     Telephone:
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Ship to: (leave blank if same)

          Name:
  Organization:
       Address:
               
          City:  State/Province:
   Postal Code:
       Country:
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Payment style required:
Cash  Check  P.O.

Actual opening size: 

Jamb type:  wood    Steel

Floor poured:  Yes    No   Floor level:  Yes    No

Door height: center           LSLD 
               RSLD 

Backroom (door throw): OK   Not OK 

Floor to ceiling height at lowest point: 
Obstructions on ceiling?           What: 

Pads:  Yes    No

Sideroom clearance?  LSLD    RSLD 
Ceiling:             flat  sloped 
                    other 

Power:           Yes    No

Disposal:        Yes    No

Driveway clear:  Yes    No

Garage clean:    Yes    No

Model        Color 	 Quantity 

Size    Insulation  Int. lock 

Windows:  Yes    No            Window size 
Window style      Quantity per section  
Section location 

Misc.



Spring and Track Type
NHR     LHR     
EXT    TORS 

Lift clearance    Vertical lift 
    Roof slope 

Note: More sideroom is required for LHR.


Operators
Door:  wood    Steel
Normal installation       Special 

Is there a header for the motor?   Yes    No
Brand:	Liftmaster      1/3 	  1/2 
	Link	        1/3 	  1/2 

Push button:   Yes    No	Quantity 
Location of push button: 

Keyswitch:  Yes    No   Quantity 
Location:  

Emergency disconnect:   Yes    No