Laserfiche WebLink
2000 Fire/Police Rapid Entry System rEUlm <br /> AUTHORIZATION/ORDER FORM ys ; <br /> Effective 1/1/2000 <br /> ORDERED BY: INSTALLATION ADDRESSES <br /> / y (Rp,ulred by Fire Department) <br /> Company/Person:&A/7)R A I /� Date: List street addresses and cities where items <br /> will be installed.Attach separate sheet for <br /> Street: l �� �rUN •IR V �lU C'i additional installation addresses. <br /> City/State: Zi G 3 1. Bldq.Name -- <br /> ContactPerson.,,%jj EE L r �f�e. Phone: ( �2S)743 ,339 Street�QDq �LL 1 GAd,-(J�1�y))A��� <br /> P.O.k (Gov. agencies only): City GA/_ _ereiU- <br /> (Orden under f700 npuln prop•rm•nr.I <br /> SHIPTO:(Street Address ONLY - No P.O.Box.) 2. Bldg.Name <br /> Company/Person 3 0,0 p E75 k ±I-)C, Slrpet <br /> / <br /> Street: fn 1)p - - BrDAdijA Aix- _ City <br /> — <br /> City/State: /1 nj- .f --t- a Zip: <br /> Contact Person:Nle 1)bL_IE l .1"F-�Phone: (y0S) t <br /> Fe <br /> • a • • a <br /> ale to: <br /> Ll : <br /> 1_11ft-Rl=n VIRE: DEPT 79,3 <br /> 2011 OAK>=S AVt= Ca <br /> Si <br /> EVFRETT WA 98201- <br /> (OVA, <br /> Oe/ <br /> A THORIZE FIRE AGENCY SIGN RE St <br /> PS 10-0.2.2 _ VE <br /> System Code <br /> USE rrr PRODUCT PRICE LIST ON OF r Section4 <br /> Oty. Part w Item Description Color weight Price Es. Total IMPORTANT <br /> p n9 _ oV ❑ Check here if <br /> a products ordered on <br /> this form must be <br /> DUAL KEYED <br /> MAKE G_NECKS PAYABLE TO: KNOX COMPANY suBTorAL r S <br /> Add $7.00 to EACH <br /> Send This Form Shipping & Handling Add Sales Tax II Applicable item ordered <br /> Payment r for: CA•,GA, IL, NJ,OH $ <br /> 1 Ib. to 25 lbs. $10.00 Shipping&Handling $ /0- 0 <br /> I COMPANY 26 lbs.to 50 lbs. $20.00 TOTAL: $ ']�S ' ®BoNOX <br /> P.O. Box 51 lbs. to 75 lbs. $30.00 800.552.5669. 949.252.8181 <br /> Irvine. CA 92623-9699 75lbs.rcall X=frquofe. •CATox:7.25% • CA,Orange County Tax:7.75% Fax: 949.252-0482 <br /> www.knoxbox.com <br /> 04M 0 CopI ti9j-KNOX COMPANY 1999 <br />