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 one week of items being picked-up.

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

• Delivery / Pick-Up to the address below; 48 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.

• Three Week lead time minimum, Lead times are based on the number of items to be UL Listed and the complexity of the assembly. RUSH ORDERS are an additional 30% of the total job cost.

Delivery Details

• Deliveries and pick ups are only accepted between 9:00 AM - 4:00 PM, M-W.

• Deliveries and pick ups need to be scheduled 48 hours in advance.

ALL JOBS MUST BE PICKED UP WITHIN 48 HRS OF NOTICE OF COMPLETION. IF THEY ARE NOT YOU WILL BE CHAGRED A STORAGE FEE OF $50 DAY.

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