Aleco Order Number:

Date: ___ / ___ / ___

DOOR FEATURES & OPTIONSTEAR-DROP BUMPERS (POLYETHYLENE)

[ ] 12" High[ ] 18" High[ ] 24" High

[ ] 36" High[ ] 42" High[ ] 48" High

IMPACT PANELS

JAMB CONSTRUCTIONHinge requires a minimum double 2x4 wood jamb.

OPTIONAL FACINGS (Check one) [ ] ABS is standard[ ] Anodized Aluminum, [ ] Stainless Steel, [ ] High Pressure Laminates (Formica , Wilson Art , or Nevamar )Name: ______________ Laminate #: _________________

P/N 9941330712

Aleco Part Number:

Account Number:

Sold To:Address:

Purchase Order #:

Ship To:Address:

Special Markings/Instructions:

Quantity: Single or Bi-Parting (check one)

Net Opening: _____" Wide _____" High

Please fill out specifications form and send to Aleco. Add dimensions to illustration below. Signature is required before production can begin.

Specifications: 3/4" Solid Core, Rigid

WINDOW SIZES (Rectangular Dual Pane Mechanically Fastened)

11 1/2" x 15 1/2" is standard[ ] 7 1/2" x 10 1/2"[ ] 16" x 18"[ ] Single Pane Gasketed Option

Approved: ______________________________Date: ______________

IMPORTANT! SIGNATURE REQUIRED BEFORE PRODUCTION

I have reviewed the specifications and authorize Aleco tobegin immediate manufacturing ofI understand that this product will be custom made to myorder specifications and is non-returnable.

ImpacDor FS-500.

Company Name: _______________________ Phone: _____________

APPROXIMATE WEIGHT

5.0 lbs. per sq. ft. X ___________ sq. ft. = ____________ lbs.

SignHereJAMB GUARD/HINGE

[ ] ABS ____"High[ ] 18 ga. Stainless Steel ____"High

SEALSNon-Gasketed is standard

SPECIAL OPTIONS / NOTES

___________________________________________________________

___________________________________________________________

___________________________________________________________

Frame (shaded portion) not included.

[ ]

Stainless Steel EZ Hinge with 8 3/4” high x 3”deep jamb guards is standard

[ ]

2720 E. Avalon Ave. Muscle Shoals AL, 35661 • Phone (256) 248-2402 or toll free 1-800-633-3120Fax: 1-800-750-9616 • email: info@aleco.com • web: www.aleco.com