Replacement parts Order form

for LuxEAir series

How To Use:

1.Find your part on the map and make note of its number & letter.

2.Using map number and letter, choose part number and select color (or finish) on parts list provided on page 32-33.

3.Fill out the form below with the selected information. Fax or send to Aquatic.

4.Call Aquatic for parts pricing and shipping charges.

IMPORTANT!

The following information must accompany your order:

Serial Number, Model Number/Name, Purchase Date and Color

Please fill out completely:

SHIP TO:

 

 

 

 

 

 

 

 

 

 

BILL TO:

 

 

 

 

 

 

 

 

 

 

Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Company

 

 

 

 

 

 

 

 

 

 

 

 

Company

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address

 

 

 

 

 

 

 

 

 

 

 

 

Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City

 

 

 

 

State

 

 

 

Zip

 

 

 

 

City

 

 

 

 

State

 

 

 

Zip

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Phone

 

 

 

 

 

Fax

 

 

 

 

 

Phone

 

 

 

 

Fax

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Serial # (Invoice #)

 

 

 

 

 

 

 

 

 

 

 

Model Name

 

 

 

 

 

 

 

 

 

 

Model #

 

 

 

 

 

 

 

 

color

 

 

Purchase Date

 

 

 

 

Quantity

 

Part No.

Description

Color/Finish

 

Price

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Mail orders to:

AQUATIC INDUSTRIES, Inc.

P.O. Box 889 • Leander, TX 78646-0889

Phone (800) 928-3707 • Fax (888) 296-7450

28

Aquatic Industries, Inc.

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Aquatic LuxeAir Series Replacement parts Order form, For LuxEAir series How To Use, Quantity Description, Price