CONTRACT QUOTATION FORMDATE: _

DHSI 13 Silver Street, Rochester, New York 14611

TEL: 585-235-8543 FAX: 585-235-0431Web: dhsi-seal.com

Contact: Robert Rissone, President e-mail:

Request and Take-Off By:

*CONTACT*Name of Job:

*Contractor:*City/State

*Address:*Architect:

*City/State:City/State:

*TEL:TEL:

*FAX:

*e-mail:Date Material Requested:

Grouping of products may result in additional discounts.

*The following information is required.

If a component is not specified, type in ‘none’:

Guest EntryConnectingStairwell

*Frame SealsMfg.

Part #

*Door bottomsMfg.

Part #

*ThresholdsMfg.

Part #

*Privacy GuardsMfg.

Part #

A.#105 "Cush 'N' Seal" Frame Seals: Circle Color Choice: Off-White (OW) or Dark Brown (DUR)

Frame Seals/Weatherstripping: Interior or Exterior QUANTITY SIZE

# of entry rooms3’-0 x 7’-0 (example)

# of communicating (2 / opening)x2 = _ each

# of Stairwell

# of Others

TOTAL SETS:_$

B.#CS 36 Cap Sweepex. 3’-0$_

at Entry, Connecting, Stair and other

Circle Choice Off-White (OW) or Dark Brown (DUR)

C.#CS 36 x AMU Cap Sweep$_

with Allowance and Means for Undercut option (Entry)

D.#AMDB3 Adjustable Mortise Door Bottom$_

x SWE YES or NOx AMU YES or NO

E.#AMDB3 x AMDB-CC$_

Adjustable Mortise Door Bottom with

Conversion Channel for HM doors

F.#SSDB3 Surface Door Bottom$_

x AMU YES or NO

Cover Color: OW, Duro, AL or Champagne

G.#SAS: “Secur-A-Seal” automatic door bottom$_

Frame Color: Handing:

Cover Color: OW, Duro, AL or Champagne

H.#SAL: “Secur-A-Latch” Privacy Keeper finish$_

I.#SPC Strike Plate Cover (for use with SAL)$_

J.#SA-7: Self Adhesive Surface AstragalOW or DB7’-0$_

K.#SA-8: Self Adhesive Surface AstragalOW or DB8’-0$_

L.#AMA3 Adjustable Mortise Astragal$_

M.#FT 2.75 Fire Threshold Black - Entry$

N.#FA/SB Frame Alignment/Security Brackets$

O.#CTT 2.75 Carpet-to-tile Threshold Black – Entry3’-0$

P.#TTT 2.75 Tile-to-tile Threshold Black – Entry3’-0$

Q.#CTC-ADJ Fire Threshold Black3’-0$

Anything over the standard FT 2.75 Threshold, up to 12” wide – at connecting

R.# HS 2.75 Fire Threshold Black (ex. Stair)$_

S.# FS 5.50 Fire Threshold Black (Full Saddle)$_

T.# DP.25 Dust Plug (1 each for 12 doors)12”$_

U. ADD FOR FREIGHT: Estimated $_

All freight costs are based upon estimate weight at time of quotation. Actual cost may vary at time of shipment.

V.NY State TAX:$

* Buyer agrees to pay tax outside NYS direct to the taxing authority in the state where applicable

W.DHSI will calculate and return: GRAND TOTAL $_

TERMS: Net 30 from day of receipt of material. All quotes are in U.S. Funds. Past due invoices are subject to penalties as allowed by individual state codes. Delays in completing the appropriate Architectural Details and the formal acknowledgement of the Industry Guidelines and Recommended Clearances forms will delay shipment. The training materials and related forms are COPYRIGHT and it is agreed that they will not be duplicated, nor allowed to be duplicated by any other person or organization. They remain the property of DHSI. Use is for specific sites only and by the owner (Operations Manager) for training. Buyer agrees not to compromise the intended use of "Cush 'N' Seal" by using it as a frame seal with other manufacturer’s products. These terms and conditions preclude any terms and conditions as may appear on any P.O. issued by the buyer and/or user and is agreed upon by issuance of such P.O. Material supply only-not a labor subcontract-No retainage. This quote is good for 30 days from date of issue. Installation constitutes acceptance of the product. Consult DHSI for current production lead times. Distributors must agree not to mix our sealing systems products with other manufacturer’s sealing systems products, such as our frame seals with other mfg door bottoms.

Accepted By:DOOR AND HARDWARE SYSTEMS, INC.

Company:Date:

Date:By:

Date Material is Requested:CQFH-01