Printed Form: FOR CONFIRMATION PRICE ONLY DATE_____________04 DEALERCODE _______________ REQUEST NUMBER ____________________ PAGE TWO OF __________ ROUGH OPENING HEIGHT ______________ WIDTH _________________________IN INCHES ROUGH OPENING HEIGHT ______________ WIDTH ______________IN METRIC DOOR STYLE MODEL NUMBER _____________CUSTOM DESIGN ____________________________________ DOOR TYPE A_B_C_D_E_f_G_OTHER ______________________________________________ DOOR HANDLE STYLE OUTSIDE __________________FINISH _________________________ DOOR HANDLE STYLE INSIDE ___________________FINISH _________________________ DOOR MATERIAL OAK ______ALDER ______PINE ______ MAPLE ______OTHER __________ DOOR COLOR INSIDE ______________________COLOR OUTSIDE ______________________ FRAME DEPTH __________________STD DEPTH IS __________________OTHER _________ GLASS OPTIONS ______________________________________________________________ HINGE DIRECTION INSIDE L ____INSIDE R ____OUTSIDE L ____OUTSIDE R __________ HINGE STYLE _____________________________ HINGE FINISH _____________________ KEYS REQUIRED FOR EACH LOCKING SYSTEM QTY EACH LOCK ________________________ LOCKING SYSTEM _________ FINISH INSIDE ________ FINISH OUTSIDE _____________ PANIC DOORHANDLES INSIDE _____________ INSIDE SLIDING BOLT _________________ METAL TRIM STYLE ________________________ METAL TRIM FINISH ________________ PEEP HOLE HEIGHT IF REQUIRED MM FROM FLOOR _________________________________ SECURITY LEVEL _______________ SHIPPING BOX LABEL __________________________ SPECIAL FEATURES ___________________________________________________________ SIDE LITES LEFT ____________ SIDE LITE RIGHT _____________TOP LITE _________ THRESHOLD STYLE STANDARD _________ FLUSH ____________ NONE _________________ WOOD OR OTHER MATERIAL INSIDE ______________________________________________ WOOD OR OTHER MATERIAL OUTSIDE _____________________________________________ COST OF DOOR $__________.00 SHIPPING FOB MIAMI $_________.00 SPECIAL FEATURES $__________.00 CUSTOMS UKRAINE $_________.00 SHIPPING FROM FACTORY $__________.00 USA CUSTOMS FEES $_________.00 TOTAL ANTICIPATED DEALER COST THIS ITEM $_________.00 ATTACH AN ADDITIONAL PAGE FOR DETAILS OR QUESTIONS NOT LISTED