GEM FREQUENT CUSTOMER ORDER FORM

This page was recently created in order to expedite the order process for our frequent customers. If there are any problems using this page, please email us and let us know. If you would like to fill out and fax us a form, click here to download a MS Word document. You may also download the document, fill it in with MS Word, save it, and email it to us if you prefer.

Please enter the information for your order here.
Customer ID*
Customer PO*
Email Address*
Contact Name*
		*required fields
Company Name
Shipping Address
City, State, ZIP
Telephone
Shipping Method		(UPS Ground unless indicated)
One Motor Remote System - GR1		Qty:   115/230VAC   230VAC only
One Motor Remote System w/ Auto-Stop - GR1A		Qty:   115/230VAC   230VAC only
Two Motor Remote System - GR2		Qty:   115/230VAC   230VAC only
Two Motor Remote System w/ Auto-Stop - GR2A		Qty:   115/230VAC   230VAC only
Four Motor Remote System - GR4		Qty:   230VAC only
Four Motor Remote System w/ Auto-Stop - GR4A		Qty:   230VAC only
Personal Water Craft One Motor Remote System - GRP1		Qty:
Two for One Remote System - GR2F1		Qty:   115/230VAC   230VAC only
E-Drive Limit Switch - KELS		Qty:   10 Ft.
Flat Plate Limit Switch - KFLS		Qty:   10 Ft.   20 Ft.   25 Ft.
All Metal Old Style (2000 to July 2005)- KFLS-METALBHUS		Qty:   10 Ft.
Rotary Limit Switch - KRLS		Qty:   20 Ft.   High Tide Mount
Two Button Miniature Transmitter - 6230		Qty:
Three Button Miniature Transmitter - 7240		Qty:
Upgrade Kit: 8832 to 7004 - K7004A		Qty:
Upgrade Kit: Air hose PWC to GRP1 - KAIRUPGRADE		Qty:
GFI		Qty:
Transformer		Qty:
Special Instructions/Comments