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AquaAlert Products
WatchDog Products
DA Series
LD Series

Fan Status & Control Order Form
Panels
PRODUCTMODELQUANTITY
Fan Status Control Station Panels
Suppression System Purge Panel
Options
# of LEDs Needed
Your PO Number
Activating Device
Control Panel
Common
Flush Mounting YES    NO
3-Position Toggle YES   NO Quantity:
2-Position Toggle YES   NO Quantity:
3-Position Rotary YES   NO Quantity:
2-Position Rotary YES   NO Quantity:
U.L. Required YES    NO
Power Supply YES    NO
Sonalert/Silence YES    NO
Panel Orientation Vertical    Horizontal
Frontlit/Backlit Frontlit    Backlit
More Than One Control Panel Connection? YES    NO

Your Contact Info
Company
First Name
Last Name
Email
Telephone

Your Physical Address
Street Address
City
State
Zip Code
Country

Your Billing Address
Billing Same As Above? YES NO
Street Address
City
State
Zip Code
Country

Shipping Method
UPS Next Day Air
UPS Next Day Saver
UPS Second Day
UPS Third Day
UPS Ground

Questions & Comments


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