
LEXYZ27 Order Form
Date
AVFI Sales REP
Customer Signature
To generate your order form, please refer to the informa on provided below to insert the alphabe c and/or numeric code in the respec ve
category boxes. Please note that without this fi lled out Order Form, your purchase cannot be processed.
1
Product Model
2
Finish
3
Chargeable Accessories (One Code Per Box)
Quote No.
Customer No.
AVFI No.
OFFICE USE ONLY
Offi ce Use Only
4
Custom
Cutouts
LEXYZ27
Choose Model Style (Front Panel)
1
Code LEXYZ27
Choose Product Finish
2
Standard Finishes (Ships within 1-15 business days)
Code BPL
(Bartle Pearwood)
OpƟ onal Finishes (Ships within 20 business days)
MPL ARL
BWL
Code BRL
(Baroque)
WHL
STL
Code CHL
(Cherry Hill Plank)
BKL
Chargeable Accessories (Check all that apply)
3
Code O0
Code D1
*
Code D2
*
Code E1
Code E3
Code E7
*
Code EA
*
Code EB
*
Code EC
*
Code EF
*
Code ED
**
Cutout Required (Extra Charges will apply) Requires CHGQIW/B accessory
*
Comments (Please use this sec on to provide addi onal informa on)
No Accessories
MIC-18 MX418 S/C Microphone Qty______
LIGHT-18 Gooseneck Light Qty______
PB 6 Outlet Power Bar Qty______
CUB3 Round Cable Well Qty______
PC-PATCH Power-Data Module Qty______
CUB4S Silver Power Panel Qty______
CUB4B Black Power Panel Qty______
CHGQIW Wireless Charging Sta on White Qty______
CHGQIB Wireless Charging Sta on Black Qty______
CHGQI-DNGL Dongle Lightning Qty______
**
_____________________________________________
_____________________________________________
_____________________________________________
_____________________________________________
Notes
Custom Cutout Op on (Extra charges will apply)
4
Please indicate custom cutout loca on on the drawing below
Grommet
Code C0 No Custom Cutout
Code CC Custom Cutout (Specify on Cutout Area Above)
Cutout Area (16.23”W X 6.50”D)
CAD Drawings/Symbols
CAD drawings are available by request at sales@vegroup.net
Custom Cutouts
Es mated lead me within 20 business days from receipt of P.O. and signed drawings.
CustomizaƟ ons
Modifi ca ons to design such as shape and/or size varia ons have to be quoted on a per
case basis and are applicable for quan es of 10+ only.
www.video-furn.com
sales@video-furn.com 1-877-834-3876