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Knox Box Authorization Order Form
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Steps
1.
Step One
This section is complete
This section is incomplete
2.
Step Two
This section is complete
This section is incomplete
3.
Step Three
This section is complete
This section is incomplete
Step One
Section 1: Ordered By
Ordered By
Contractor
Government/Military
Property Owner
Product For
Campus/School
Commercial Property
Government
Healthcare
Hospitality/Hotels
Military
Other
Company/Agency
Date Ordered
Date Ordered
Street Address
Suite/Building
City
State
ZIP Code
Contact Name
P.O. Number (Government Agencies Only)
Phone Number
Email Adderss
Section 2
Continue
Step Two
Section 3: Order Product
Use the
attached price list (PDF)
.
Quantity and Weight (Each)
Model Number
Price (Each)
Extended Price
Quantity and Weight (Each)
Model Number
Price (Each)
Extended Price
Quantity and Weight (Each)
Model Number
Price (Each)
Extended Price
Sub-Master Fee
(if required, $7 each)
Shipping and Handling
Ground Shipping & Handling
1 to 7 pounds is $15
8 to 16 pounds is $28
17 to 30 pounds is $42
31 to 50 pounds is $52
51 to 75 pounds is $62
Rush?
Next Day Air
2nd Day Air
Call for rates and check which box.
Subtotal
Sales Tax
California tax required.
Pre-Payment Total
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Step Three
Section 4
Installation Address - Required By Authorized Agency
New Construction
Retrofit
Building Name
(Where the item will be installed)
Address
No P.O. boxes.
City
State
Zip Code
Section 5
Ship to Address is Required
Same as Install Address
Different Address
Address
City
State
Zip Code
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