Number of Units: Purchase Order#:
Customer Name: Date Received:
Job Name: Quote Valid Until:
Address: City: State:
Quote Entered By: Email Address:
Contact Info: Cell# Work: Fax:

Shell: Light:
Buss Bar: Rec Color: Faceplate Color:
Receptacle 1: Receptacle 4
Receptacle 2 Receptacle 5
Receptacle 3 Receptacle 6
Water
Base Light
Quantity
Base
Additional Notes:
Kilowatt Hour Meter:
Quantity:

Kilowatt Hour Meter:
Quantity:
Event Breakers:
Quantity:
Event Breakers:
Quantity:
Water Meter Quantity:
Extra Cover:
Quantity: