UL Listing Order Form

Name*

First NameLast Name

Company Name*

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number*

Please enter a valid phone number.

Email*

example@example.com

Submission Date (Today)*

Date

Job Name*

All items are to be delivered and picked up by the client to the following address, with a required 24 hr notice:

OM DESIGN - UL LISTING

26 SHAWNEE WAY, UNIT A

BOZEMAN, MT 59715

Upload Images - Required for All Items*

All Additional Items Requested to be installed or replaced:*

How many Units?*

Rewire?*

YesNo

If yes, please provide your preferred cording color. (If no, type "no")*

Replace Socket?*

YesNo

New Canopy or Mounting Plate?*

YesNo

If yes, please provide your preferred mounting plate material request (If no, type "no")*

If yes, please provide your preferred mounting plate finish color (If no, type "no")*

Requested Shape and Size of Canopy or Mountain Plate*

Please include all measurements for Height, Width and Length.

New Downstem?*

YesNo

If yes, please provide your preferred downstem length (If no, type "no")*

If yes, please provide your preferred downstem material (If no, type "no")*

If yes, please provide your preferred downstem finish color (If no, type "no")*

Is the house or building wired with LUTRON SYSTEM?

YesNo

UL Listing Invoice Details

• Final Payment is due within two weeks of items being picked-up.

• Prices are based on information provided to date. Not including TBD items.

• Delivery / Pick-Up to the address below; 24 hour notice required.

26 Shawnee Way, Unit A, Bozeman, MT 59715

• Installation instructions are provided for each item by the manufacturer, NOT OM Design, and MUST be followed accordingly.

• Lead times are based on the number of items to be UL Listed and the complexity of the assembly. RUSH ORDERS are an additional 20% of the total job cost.

Delivery Details

• Deliveries and pick ups are only accepted between 9 o’clock and 4 o’clock Monday, Tuesday, and Wednesday.

• Deliveries and pick ups need to be scheduled 24 hours in advance.

Delivery Scheduling
A scheduled appointment is required for all deliveries. Please select the day and time you will be dropping items off.

Delivery Format

For all deliveries, please make an appointment:

By selecting, I agree to the delivery terms.

(for OM Design Use Only) Packaging

For OM Design use only

UL Listing - Order Form

UL Listing Invoice Details

Delivery Details