ELECTRODYN Quote Request
If you cannot submit this form via the Internet, please print it and fax to: 954-656-8839.
Fire Service Retrofit - the "Red Box"
Company
Address
City
State
Zip Code
Company Rep
Office Phone
Cell Phone
Fax
eFax
eMail
Model 712
Building name
Controller type
Drawing Number
Number of cars
Is job print available?
Yes
No
Type
Simplex
Duplex
Triplex
Group
State and year code
Number of floors
OTIS
OTIS Touch Tube
OTIS Mechanical Buttons
Landing 1
2
3
4
5
6
7
8
9
10
Floor markings
Please enter actual marking, e.g. "B","L","1".
Normal return landing
Alternate return landing
Number of cars with opposing front and rear doors
Is door detector present?
Yes
No
Door operator type
Voltage
AC
DC
Is emergency power present?
Yes
No
Manual
Auto
If an OTIS model, are you using OTIS fixtures?
Yes
No
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