Name

First Name

Last Name

Company Name

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Submission Date

Today's Date

YYYY

Job Name

All items are to be delivered and picked up by the client to the following address, with a required hr notice:

OM DESIGN - UL LISTING 26 SHAWNEE WAY, UNIT A BOZEMAN, MT 59715

All Additional Items Requested to be installed or replaced:

How many units?

e.g. 23

New Canopy or Mounting Plate?

Yes

If yes, please provide your preferred mounting plate finish (If no, type "no")

Requested Shape and Size of Canopy or Mountain Plate

Please include all measurements for Height, Width and Length.

New Downstem?

Yes

UL Listing Invoice Details

Final Payment is due within two weeks of items being picked-up. Prices are based on information provided to date. Not including TBD items. Delivery / Pick-Up to the address below; 24 hour notice required. 26 Shawnee Way, Unit A, Bozeman, MT 59715 Installation instructions are provided for each item by the manufacturer, NOT Oм Design, and MUST be followed accordingly. Lead times are based on the number of items to be UL Listed and the complexity of the assembly. RUSH ORDERS are an additional 20% of the total job cost.

Delivery Details

Deliveries and pick ups are only accepted between 9 o'clock and 4 o'clock Monday - Thursday Deliveries and pick ups need to be scheduled 48 hours in advance.

UL Listing Order Form