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<br />JOB ADDRESS <br /> <br />~ <br /> <br />rolleden <br />>~~~ <br /> <br />CiTY <br /> <br />~ <br /> <br />rolleden <br /> <br />CUSTOMER NAME ~MtJ II <br />BILLING ADDRESS ~f) <br /> <br />~~ <br /> <br />ROLLADENINCORPORATED <br /> <br />TELEPHONE <br />OTHER PHONE <br /> <br /> <br />We propose to furnish and install the following: <br /> <br />Unit Prdl- Slid Win Entry Room Opening Size Doe lion lIS Profile 01S Profile Fllme <br />No. Door Door Width Height Manual Clink Motor Mlr/Or Color Color CoI~ <br />1 Ptr X IJ c?,n 1JCf- x.. <6(P X X A -f/ (). tld r:::? <br />2 <br />3 <br />4 <br />5 <br />6 <br />7 <br />8 <br />, <br />9 <br />10 <br />/ Total openings to be covered (muJliple count as one). Units are numbered from left to right from: Inside _ Outside _ <br />Filler Panel(s) to be located in section No. . and No. and No. None <br />- -, - <br /> <br />Shutter(s) to be Installed. InSide LJ Outside CJ <br /> <br />Rear <br />Indicate by number <br />counter clockwise <br />(g) OMIT <br />Front <br /> <br />TOTAL AMOUNT 00 . t/O <br /> <br />DEPOSIT (\I Mln, Required) 0 . 00 <br /> <br />BAL. DUE c.o,o. Pay InSlall., t}ZJ - CJ <br /> <br />Installation estimated to begin in approximately ~ <br />to weeks from date of receipt of deposit. This <br />is only an estimated date and you will be contacted to <br />schedule the actual installation date, <br /> <br />Special Instructions: <br /> <br />/'l2~, <br /> <br />(../.J l~ <br /> <br />1?4cyJ <br /> <br />/!-'L{ ~ <br /> <br />Electrical hook-up included in this price? YES 1<1.. NO [] Surface Mount IJ Recessed 0 <br />TERMS OF PAYMENT: BALANCE OF PAYMENT IS DUE UPON INSTALLATION, In those cases where electrical hook-up is to be pertormed by Rolladen <br />or its authorized sub-contractor, a maximum of ten percent (10%) of the contract amount may be retained pending completion of same, <br />r <br />FLOOR OF BUILDING I S OWNER OF PROPERY? YES~ NO 0 (If NO, fill in Owner's name and address <br />Is "high-work" reqUired? YES l= NO ~ In space prOVided at top of form,) <br /> <br />Products are to be Installed on the premises situated In p~_O _ County, Slate of fi- <br />as: Lot Block ~~__, Sub Division. <br /> <br />owned by Purchaser and deSCribed <br /> <br />CONTRACT SUBJECT TO ADDITIONAL TERMS ON REVERSE SIDE <br /> <br />"BUYERS RIGHT TO CANCEL" <br />"This is a home solicitation sale, and If you do not want the goods or services, you may cancel this agreement <br />by providing written notice to the seller In person, by telegram, or by mall. This notice must indicate that you do <br />not want the goods or services and must be delivered or postmarked before midnight of the third business day <br />after you sign this agreement. If you cancel this agreement, the seller may not keep all or part of any cash <br />downpayment." <br />EXECUTED IN SIX COP~, ONE C~ WH~ WAS DtlJVERED TO, AND RECEIPT IS HEREBY ACKNOWLEDGED <br />B~~rUHIS ~- DAY OF ---------: L- ,19 :.>. <br /> <br />? .... .~~...- ''I ~1r;~~ <br /> <br />(X) ._ <br /> <br />Accupied 8. Approvud <br /> <br />(Purchaser Sign ^H"ro) <br /> <br />rmnf'l~ NO <br /> <br />7SP;?;<'7~9 <br /> <br />PaQ6 <br /> <br />of ~__^ <br />