Housing Devices, Inc. - ADA1000 Request for Quotation Form

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Request for Quotation
for ADA-1000 Area of Rescue / Area of Refuge Two-Way Communication System

To submit your request for quotation online, please provide us with the following information. Those fields marked as *required are essential to our ability to respond to your request and will be mandatory for your request to be submitted.

Optionally, you may print out this page and FAX it to us at 1-781-395-8000.

Please call 1-800-392-5200 with any questions or for assistance in completing this form.

Contact Information
Your Name *required
Company *required
Address
City
State *required
Zip Code
Phone *required
Fax *required
E-mail Address *required

Describe the Equipment Please complete ALL fields in this section so that we may respond to your request as effectively as possible.
How many ADA-1000 Area Stations? (Zones)	(1 - 60)
How will the ADA-1000 Area Stations be mounted? (Surface is used for existing structures: unit is mounted on the wall surface) (Flush is used for new construction: unit is mounted in the wall during construction)

Optional Equipment
Braille Signs (1 for each Area Station)	(1 - 60)
Area of Rescue Illuminated Sign with Battery Back-up	(1 - 60)
Area of Rescue Illuminated Sign AC only	(1 - 60)
ADA-121-RM Remote strobe	(1 - 60)
ADA-121-RM remote Strobe color (White is standard)

Housing Devices, Inc. will add the appropriate amplifier or amplifier cabinet, control board, relay card (1 is used for each area station quoted), relay card cabinet and transformer with each quote, depending on the type of the battery back-up system selected. Tamperproof hardware and tamper socket are also provided with each system.