Hussey Job No



|[pic] |[pic] |PLEASE PROVIDE COMPLETE INFORMATION BASED ON DRAWINGS |

| | |AND SPECIFICATIONS. ITEMS MARKED WITH |

| | |ARE REQUIRED PROJECT DETAILS. |

|1. Customer (Billing) Information | Hussey Dealer (or) Other / Direct Sale |

|*COMPANY NAME |      |

|*Contact Person: |      Project Manager       |

|*Phone Number: |      |Fax Number: |      |

|*E-MAIL ADDRESS: |      |Paper Submittal Drawings Requested: |

|The following information must be supplied for Direct Customers. Hussey Dealers do not need to complete the following section. |

|Billing Address: |      |

| |      |

|City: |      |State or Province: |      |

|Zip or Postal Code: |      |Country: |      |

|2. Current Requirements / Objectives |*Date Required | |*Date Required |

|CAD Proposal Plan or Section | |      |Electrical Requirements | |      |

|Proposal Hand Sketch | |      |Junction Box Layout | |      |

|Quotation (Budget Pricing) | |      |Technical Specifications | |      |

|Quotation (Firm Pricing) | |      |Design Details (Attach requirements) | |      |

|Re-Quote (Original Number:     ) | |      |Bid Submittals (Attach requirements) | |      |

| DATA SHEET BEING SUBMITTED FOR ORDER ENTRY |Sightline Study | |      |

Please note: CAD Proposal drawings will be provided in Auto-CAD R14 format, unless requested otherwise.

|3. Project Name and Location (Shipping Address) |

|*Project Name:       |*Facility:       |

|Company (or “C/O”) |      |Contact Person: |      |

|Phone Number: |      |Fax Number: |      |

|Physical Address: |      |

| |      |*COUNTY |      |

|*City: |      |*State/Province: |      |

|*ZIP / POSTAL CODE: |      |*Country: |      |

4. Project Information

|*Bid DATE: |      |

|*Desired SEAT COUNT |      |

|*Source of Sales Lead: |

| Sweet’s Dodge Report Advertisement Web |

|Word of Mouth Repeat Customer Direct Mail |

|Other:       |

|Project Type: | New or Replacement |

|*Requested Ship Date: |      |

|*Requested Freight Term: | FOB Factory |

| |FOB Job Site (USA Only) |

| |Other:       |

|Freight Carrier or Forwarder: |      |

|Project Completion Date: |      |

|*Who will install? |Person: |      |

| |Company: |      |

|*Type of labor to be used: | Union |

| |Non-Union |

| |Prevailing |

|What other Hussey products are | |

|required for this project? |MAXAM 26 |

| |Fixed Seating |

| |Concertina Stage |

| |Other:       |

| | |

|*Who is project bidding to? |Architect Owner |

| |GC Const. Mgr |

| |Other:       |

|*Spec’d/approved: | Hussey Irwin Interkal Other |

|Penalty for Late Installation? | yes no |

|If Yes, specify: |      |

|*Building Code / Year: |      |

|***smoke-protected? | yes no |

|Is this Project / Specification subject to LEEDS™ or other |

| Green Building construction requirements? Yes No |

| If Yes, please submit applicable details with this Data Sheet. |

|Other applicable code(s): |      |

|Has a sample been ordered? | yes no |

|If yes, sample order number: |      |

|Based on Hussey Drawing? | yes no |

|Proposal Drawing Number? |      Revision:       |

|Waive Submittal Drawings and Field | yes no |

|Check? | |

|*Market Category? |

| Education Sr. High School | Stadium |

| Education Jr. High School | Convention Center |

| Education College/University | Arena |

| Worship | Other Indoor |

|*** Project Architect or Owner can indicate whether a facility meets |

|the local definition of “smoke-protected.” This determination can |

|affect layout and seat count. |

|MAXAM Plus Data Sheet |Project name:       |

|5. Product Selections |

|MODEL |Bank |A |B |C |D |

|Fixed Seating | | | | | |

|(check all that apply and detail quantities in Notes section) |Reverse Fold | | | | |

|SEAT TYPE |RF Delayed Action | | | | |

|(polymer: | | | | | |

|monochromatic) | | | | | |

|Courtside Graphic Logos Yes No |Wood | | | | | |

|Note: Describe specific location of spacers in Pg. 3 notes |Contour (Plastic) | | | | | |

|Classic Wood | |

| Signature Logo Program (Hussey-Designed - $200) |Metro Chair: (on MAXAM Plus Only) |

| Standard Hussey Block Lettering With Shadow |If Metro Chairs are required, please indicate needs on the Metro |

| No Logo / Lettering |Telescopic Seating Supplemental Data Sheet. |

|6. Bank Information | |

|*WALL CONSTRUCTION: |      |*FLOOR CONSTRUCTION: |      |

|Desired Top Frame Attachment (On Wall Attached Banks): Floor (standard) or Lower Wall |

| |# of |

| |Rows |

|MAXAM Plus Row Spacing Choices: |30” [762mm], 32” [813mm], 33” [838mm] |

|7. Options |

|OPERATION |

|*PROJECT POWER SUPPLY required on all projects: |Volts:       |Phase:       |Hertz (Hz):       |

|PERMANENT FRONT CUT-OUTS (quantity per bank) |TOP ROW FILLERS |

|3’-0” [914mm] Cut-outs |   |

| |FULL SECTION TRUNCATIONS (Front Panel included.) (Quantity per bank) |

| |Full Section Permanent |      |      |      |      |

| |Full Section Recoverable |      |      |      |      |

| |How many rows deep? |      |      |      |      |

|FLEX-ROW Layout (One Row Deep): Please describe customer’s front row needs below. If Flex Row is chosen, system will require |

| 2nd Tier Power. If Metro Chairs are chosen, Metros on Flex Rows will be Manual Fold Down. |

| ADA or Wheelchair spaces required to applicable codes. |

|Scorer’s Table Seating needed (Attach sketch showing amount of space needed [feet or meters] and desired location). |

|Team Seating needed (Attach sketch showing amount of space needed [feet or meters] and desired location). |

|Other Front Row / Flex-Row Needs (Describe in “comments” area, or attach sketch). |

|Rails Required at Row Z |

|MAXAM Plus Data Sheet |Project name:       |

|8. MVP & Deck Detail |

|Deck Type / Finish | Plywood / Clear | Polydeck / Gray | Aluminum Decking |

|Plastic Colors |Courtside:       |Riser (16" Rise only):       |Contour Backrest:       |

| Please attach or e-mail desired Logo / Lettering Layout |

| |

|Flammability Standard: | | |

| CAL TB 117 | CAL TB 133 | BS 5852 Crib 5 | Other:       |

| |

|9. Accessories |

| |Bank |A |B |C |D |Panels |

| (*Provide section sketch of balcony for transition) |Rear Panel | | | | |

|Aisle Lights | | | | |Rear Panel Height: 8’0 [2440mm] Max. or Full Height |

|Elevated Front Aisle (EFA) | | | | |Panel Material (for all Front, Rear & End Panels) |

| Please indicate EFA tier height |   |   |   |   | Plywood |Polydeck: Gray or Beige |

| Please indicate EFA width in inches or mm:       |Miscellaneous |

|Steel Aisle Rail | | | | |Carp| |

| | | | | |eted| |

| | | | | |Deck| |

| | | | | |s: | |

| | | | | |Colo| |

| | | | | |r: | |

|END RAILS, 4” [102mm] SPHERE |Scorer’s Table by Hussey (qty) | |   |   |   |   |

| Steel Self-Storing | | | | |Operating Handles, number of additional Pairs:       | | |

| Removable Rails | | | | |Vent Grilles by Hussey (pairs) |

| Steel Front Rail | | | | | |Std. quantity – 1 pair per secured/aligned section |

| Steel Rear Rail | | | | | |

| Color Match Steel Rails? |Color | |as number of floor pintles) |Qty. | | | |

| |to be:| | | | | | |

| |      | | | | | | |

| |Barrier Belts for Flex-Row |Qty: |      |Sizes: |      |

|End Curtains |Skirt Board Locks (manual systems) | | | | |

| |

|Unless otherwise requested, your MAXAM order will include a standard submittal package, |

|consisting of emailed 11’ x 17” PDF submittal drawings. If other submittal information is required by customer or |

|specification, please indicate needs below. Hussey may request copy of specification to ensure needs are met. |

|All hard copy submittal materials will be mailed via ground service unless specified otherwise in area #11 below. |

| Please mail six (6) B-size black and white submittal drawings | Product Catalogs |Qty:    |

| Additional Drawings |Size:       |Quantity:    | Paint/Plastic Selector Card |Qty:    |

| | | | | | |

| Wheel Location Plan | Wheel Load Bearing Data |

| State of Manufacture Engineering Stamp | Structural Calculations |

| Engineering Stamp other state:       | |

| Other (please indicate):       |DSA Requirements (California Only)* |

|Vinyl End Curtains | | DSA Approved Structural Calculations |

|Logo proofs required: electronic proof | | DSA Approved Submittal Drawings |

| | | California Engineer’s Stamp |

| |* There may be Lead Time and Cost impacts for this option |

| | | | |

|11. Additional Instructions/Comments |

|For electronic filing, please enter text here (       |

| |

| |

|For filing by FAX, please add notes here (      |

| |

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| | | | |

|Submitted by: |      |Date: |      |

Quote number / size of ocean containers (International Only)

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