Quotation/Lighting Layout Request for EverLast® Series BLGFUS-EC: Company Name : Contact Name : * Your E-mail * State/Province : None Alabama (AL) Alaska (AK) Arizona (AZ) Arkansas (AR) California (CA) Colorado (CO) Connecticut (CT) Delaware (DE) District of Columbia (DC) Florida (FL) Georgia (GA) Guam (GU) Hawaii (HI) Idaho (ID) Illinois (IL) Indiana (IN) Iowa (IA) Kansas (KS) Kentucky (KY) Louisiana (LA) Maine (ME) Maryland (MD) Massachusetts (MA) Michigan (MI) Minnesota (MN) Mississippi (MS) Missouri (MO) Montana (MT) Nebraska (NE) Nevada (NV) New Hampshire (NH) New Jersey (NJ) New Mexico (NM) New York (NY) North Carolina (NC) North Dakota (ND) Ohio (OH) Oklahoma (OK) Oregon (OR) Pennyslvania (PA) Puerto Rico (PR) Rhode Island (RI) South Carolina (SC) South Dakota (SD) Tennessee (TN) Texas (TX) Utah (UT) Vermont (VT) Virginia (VA) Virgin Islands (VI) Washington (WA) West Virginia (WV) Wisconsin (WI) Wyoming (WY) Alberta (AB) British Columbia (BC) Manitoba (MB) New Brunswick (NB) Newfoundland and Labrador (NL) Northwest Territories (NT) Nova Scotia (NS) Nunavut (NU) Prince Edward Island (PE) Saskatchewan (SK) Ontario (ON) Quebec (QC) Yukon (YT) Postal Code : * Country : United States Canada Telephone : * Fax : How would you like to be contacted? : Email Phone Fax New installation or retrofit? : New Retrofit Ordering Information: Example: (BLGFUS-EC-100W-120V-5000K-Amber-20W) BLGFUS-EC Wattage 40W 55W 70W 100W Voltage 120-277V 347V* 480V* Color Temp 5000K 4000K* LED Color Temp Amber 5000K* LED Wattage 20W 40W* Items In Bold Come standard Items In Grey * Represent Upgrade Options Available Upon Request Fixture Quantity : Dimensions of the area to be quoted W x L : * Ceiling height of the area to be quoted : * Desired Lighting Levels : Type of Facility (warehouse, manufacturing, etc.) : Please enter any additional informationthat will help us better serve you : Validation : Please type the number shown above for security purposes * Denotes required field