HomeMy WebLinkAboutCORRESPONDENCE - GENERAL CORRESPONDENCE - 330507708/201/2003 PLED 08:06 FAX
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Fire/Law Enforcement Rapid Entry System
AUTHORIZATION/ORDER FORM
2003
ORDERED BY:
Company/Name: Kee/(h t0 (1 StSn Date -
Street:
City/State: 1nY_L._ G_[ I In - Zip; Q 2
Contact Person Phone: (q70) q l 6- 2-RL7 (Z
P.Q.# (Gov. agencies only): U
SHIP TO: (Street Address ONLY - No P.O. Box.) /I
Company/Name; Paclice a?ocl':61
Street: P, k4FP ,
City: Ft�r+L co{ �t'q 5County: Laome,Statec-o—zip:92&L4
Contact Person I Phone: (470) q(fo-LRga
E-mail: (to receive UPS tracking)
1-7 22�
Kevin Wilson
Fire Marshal
Poudre Fire Authority
102 Remington St
Fort Collins, G0 80524
A FIRE AGENCY SIGNArURE
Mini order#
Vendor/Supplier# 7179Qr?
OV # Batch #
/
PV�.�
PS-•47•-027
System Code
'Vi'n L0i 15 t�
PRINT NAME CLEARLY
INSTALLATION ADDRESSES
(Required by Fire Department)
List street addresses and cities where items
will be installed. Attach separate sheet for
additional installation addresses.
1. Bldg. Name
Street
City Zip
2. Bldg. Name
Street
city zip
Federal I.D. #95-3617853
Q Check or Money Order made payable to:
KNOX COMPANY
gi❑ MC Exp. Date:
-
1 agree to jyay the Mal a npwa ace-o" ing IV
card isstwr agrer-menr.
O/N
REC'D
Fire Dept. Use Onh
❑ Check here if products orde
on this form must be
SUBMASTEREI
Add $7.00 to EACH item order
Important Note. Keys are provided to
departmetds or other registered emltles on a
peaded basis as a courtesy, The key a
associated wan the keys and keyways are a
and maintained by the Knox Company In It
California. For questions regarding this p4
contact Knox at 800-552-5669.
Customer Service Hours:
M-F 6:00 am --400 pm PS1
®KmMA
COMPANY
800-552-5669.949-252-81f
Fax:949-252-0482
__ Order Online at www.knoxbox.com
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