Housing Devices, Inc. - ADA121 Request for Quotation Form

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Request for Quotation
for ADA-121 Audio Visual Alert 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-121 Master Stations?	(1 - 150)
How many ADA-121 Remotes for each Master? (MAX. 3 per Master Station)	(1 - 3)

Optional Equipment
DC plug-in transformers (AC tri-volt hardwired is standard)	(1 - 150)
Unlighted brass doorbell buttons	(1 - 150)
Stainless steel engraved doorbell buttons (single gang mount)	(1 - 150)

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.