XE360 Series Wireless Tubular Lock Form

Name

Phone

Service Location Address

Select Lock Chassis:

Select Lock Function:

Select Lever Option:

Broadway

Latitude

Neptune

Longitude-extended length

Select Finish Options:

619 Satin Nickel

622 Matte Black

626 Satin Chrome

Monitor if door is Open or Closed?

Agreement:

I hereby grant permission to Lamarco Systems (Project manager) to proceed with the purchase of the selected customization for my chosen locks.

Signature: