
PD3006 Order Form
Page 1 of 2
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
PD3006
Product Model
1
Code PD3006
Choose Product Finish
2
Standard Finishes (Ships within 1-15 business days)
Code BCL
(Burma Cherry)
OpƟ onal Finishes (Ships within 20 business days)
MPL ARL BRL CHL
Code BWL
(Brazilian Walnut)
Code BKL
(Black)
WHL STL
Chargeable Accessories (Check all that apply)
3
Code O0
Code A1
Code B1
Code B2
Code B3
Code B5
Code B6
Code D1
*
Code D2
*
Code D3
*
Code D4
Code E0
*
Code E1
Code E3
*
Code E4
*
Code E5
*
Code E6
*
Code E7
*
Code E8
*
Code EA
*
Code EB
*
§
Code EC
*
§
Code EF
*
Code ED
**
Code J1
Code K1
Code K3
Code K4
Code M5
Code Q1
Cutout Required (Extra Charges will apply)
*
Requires CHGQIW/B accessory Only on Flat Cutout
**
www.video-furn.com
No Accessories
SH-FL Folding Side Shelf Qty______
9031-1 1U U lity Metal Shelf Qty______
9031-2 2U U lity Metal Shelf Qty______
9031-3 3U U lity Metal Shelf Qty______
9052-2 2U Sliding Metal Drawer Qty______
9052-3 3U Sliding Metal Drawer Qty______
MIC-18 MX418 S/C Microphone Qty______
LIGHT-18 Gooseneck Light Qty______
FM3 Timer/Clock Qty______
FAN Quiet Cooling Fan (Maximum 2) Qty______
POP5 Power-Data Module Qty______
PB 6 Outlet Power Bar Qty______
CUB3 Round Cable Well Qty______
SF-PB3 3 Outlet Power Bar Qty______
CUB5 Black Round Cable Well Qty______
CUB5 Silver Round Cable Well Qty______
PC-PATCH Power-Data Module Qty______
CUB8 Table Top Cable Well 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______
9107 Lacing Bar Qty______
C900S Single Monitor Arm Qty______
PLM1022 Monitor Mount Qty______
MM1232 Monitor Mount Qty______
MCB1925 Monitor/Camera Bracket Qty______
LEV4AX4 4x Levelers for Non-Mobile Applica ons Qty______
§
Comments (Please use this sec on to provide addi onal informa on)
_____________________________________________
_____________________________________________
_____________________________________________
_____________________________________________
_____________________________________________
_____________________________________________
_____________________________________________
_____________________________________________
_____________________________________________
_____________________________________________
Notes
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.
Custom Cutout Op on on Page 2
sales@video-furn.com 1-877-834-3876

PD3006 Order Form
Page 2 of 2
Please indicate custom cutout loca on on the drawing (s) below
Date
AVFI Sales REP
Custom Cutout Op on (Extra charges will apply)
4
Customer Signature
Quote No.
Customer No.
AVFI No.
OFFICE USE ONLY
Offi ce Use Only
Code C0 No Custom Cutout
Code CC Custom Cutout (Specify on Cutout Area Above)
Cutout Area - Flat or Wedge Posi on (27.63”W X 10.69”D)
www.video-furn.com
sales@video-furn.com 1-877-834-3876