Customers name ..........................................................................................................................................
Delivery address ...........................................................................................................................................
.......................................................................................................................................................................
Contact Tel. No. for delivery.
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Manual Roller Door
Width of opening (brick to brick} .....................................mm
Height of opening (floor to underside of lintel) ...................................mm
Colour..........................................
Price quoted £.........................
Quantity........................
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Electric Roller Door
Width of opening (brick to brick} ......................................mm
Height of opening (floor to underside of lintel) .....................................mm
Colour........................................
Price quoted £......................
Quantity......................
Motor Drive Unit looking from inside * LEFT HAND SIDE * or * RIGHT HAND SIDE *
Extra remote handsets (two included) ..........................
External Manual Release Switch (Yes or No) ...............
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Please make cheques payable to Envirotek Services. Thank you.
Fax or return this form to Envirotek Services, 307, Bolton Rd, Edgworth, Bolton, BL7 0AW.
Please sign and date............................................................................