Name:

E-mail:

Company Name:

   Dealer Code:

Street Address:

City:

   State:   Zip:

Country:

Phone:

  Fax:

Truck Model:

  Chassis #:

 Rockwell Tripmaster

 Exterior Sun Visor

 Toggle Switch #7 Electric Line

 Air Conditioning

 Air Conditioning Roof Mtd

 Air Horn - Locate under hood

 AM/FM/Cass. w/spkrs & antenna

 AM/FM/Cass. no spkrs or antenna

 5# Fire Extinguisher mtd. in cab

 Chrome Plate type Radiator Guard

 Repaint cab to std. Mack color

 Plate type Radiator Guard

 Rotation roof mtd. beacon light

 Change marker lens - amber/green

 Heated Mirrors

 Moto-Mirrors

 E-Tech Change HP 350 to 400
     Increase compressor to 16.5 cfm

 E-Tech Change E7-350 to EM7-300
       (Requires Turbo Change)

 Jacobs Engine Brake

 E-Tech Change EM7-300 to E7-350
       (Requires Turbo Change)

 Install Std. PTO on Mack Trans.

 Change Mack T2180 to T2090

 PTO as above, not installed

 Change Mack T2180 to T2130

 18,000 # Taperleaf to Multileaf

 P.D.L.O. for SS462 Axle

 Hubodometer

 Semi Trailer Conn./Convert HCV

 Install HCV

 Full Trailer Conn./Convert HCV

 Straight to Coiled Trailer Hoses

 Mud Flaps/Anti-Sail/Betts B80 hld.

 SS 1/4 Fenders

 SS 1/4 Fenders w/BlackFlaps

 Racor 1000 FCS Fuel Water Sep.

 Tire Inflation kit w/30' Hose

 Tire Inflation kit w/50' Hose

 AD9 Air Dryer

 Rear Tow Hooks

 Std Wet Line Kit w/50 gal plastic
   B.O.C. mount or side mount tank,
   Air PTO, Cagle Pump, Power Tower

 Roper Pump Model 3622HBFRV
   3" NPT curbside mount w/air
   operation PTO

 3 Line wet line kit with same PTO
   & pump as above.

 Drum E-490 Blower @ 30 PSI
     w/PTO mounted L.H. side

 Falconbridge Wet Line Kit

 Cut A.F.

 Shorten WB w/44K Bogie or less

 Shorten WB w/50K Bogie or more

 Lengthen WB w/44K Bogie or less
     25" or Less

 Lengthen WB w/44K Bogie or less
     26" to 50"

 FW35 Add specifics below

 FW8 Add specifics below

 FW70 Add specifics below

 FW100 Add specifics below

 FW165 Add specifics below

Leg Height in inches:

Slide: Air  Manual   None

 20 Ton Jack

 30 Ton Jack

 Export Tool Kit

 Export Box Loose Items

 Cosmolene Bright Finish Items

 P.D.I. with Frame Touch-Up