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Inspection Tag Order Form


(Discounted when Sold in multiples of 100)
Hydro Category 1
Electric Category 1
Hydro Category 5
Electric Category 5
Escalator and Moving Walk Category 1
Escalator and Moving Walk Acceptance
Hydro Acceptance
Electric Acceptance
A18 Periodic Test Tag
NYC Periodic Test Tag
NYC Resocketing Tag
Company Name on TAG
(one time setup fee)
Comments
Requested Delivery Date : (mm/dd/yy)
Shipping Method:
Regular Ground - 7/10 days
Priority - 3/4 days
Express - 1/2 days
I am a returning customer. Information below may be omitted, except for changes
Company name:
Branch:
*Contact name:
*Telephone(XXX-XXX-XXXX):
*Email Address:
Ship TO:
Company
Attention
Address
City
State
Zip
Bill TO:Use Shipping Info
Company
Attention
Address
City
State
Zip
Payment Method:
Visa or Master Card - We will send you and Order Acknowledgement Form if necessary which must be faxed back when completed.
Established Customers P.O. No:
Authorizing Party:
Customer Type:
Elevator Contractor, Consultant or Inspection Company
University Elevator Shop or In-house maintenance organization
Building Owner/Manager/Agent
Please send me a quote first via: email fax phone
Fax (XXX-XXX-XXXX):
Please complete the section above and then click Submit Order once. You will see the order as submitted. You will be contacted shortly.
 
 
 
Technical Support: John@codedataplate.com
(281)257-0516