Please complete Order Form for each type of chair or sofa you would like to order. If there are changes between seats or seating styles, please complete one form per style. Bill To Customer # Company Name Address City State Zip Phone Email PO # Required Ship Date (Please allow 6 week lead time) Is a Liftgate Required for Delivery? Sales Rep Eric Kyle NA Ship To (If Different) Name Address City State Zip Please complete based on the floor plan you would like to order. Chair Style Azure Benz Diablo Enzo Modena Maybach Volante Other Chair Other Vehicle Sprinter Transit ProMaster SUV (Escalade/Navigator) Other Vehicle Other Year Front Seat Recovers? Yes - DR Only Yes - PA Only Yes - DR & PA Set No Do Front Seats Have Airbags? Yes No next Material Options Material Soft Touch Vinyl Leather/Vinyl Combo All Leather Customer Supplied Frame/Foam Only Leather/Vinyl Combo - Face of the chair will be leather. Surrounding sides vinyl Select Insert Material Austin Plus Vinyl Austin Cooper Vinyl Aberdeen Vinyl Allante Vinyl Monterey Leather Partners Leather Special Request Austin Plus Black Buff Truffle Sand Driftwood Medium Graph Platinum Austin Cooper Black Medium Graphite Ashes Sand Driftwood Truffle Ivory Buff Aberdeen Merlot Medium Alabaster Alabaster Pewter Chamois Fawn Latte Steerhide Chocolate Buckskin Lasso Allante Black Charcoal Gray White Sea Oyster Burgundy Wine Cinnamon Cream Bisque Parchment Pearl Grey Oxford Beachwood Light Sand Medium Gray Nu Royal Blue Hideaway Monterey Lt Camano Grey Lt Tan Med Camano Grey Black Medium Flint Graphite Partners Lt Parchment Black Black Ink Tan Lt Beige Grey Dk Grey Red Off White Snowstorm Bisque Spice Med Prarie Walnut Lt Grey Lt Graphite Dk Graphite Shale Lt SilverGrey Moondust Neutral Lt Parchment Very Dark Pewter Camel Ranch Tan Crimson Insert Special Request Special Sew Style Request Perforation Perf No Perf NOTE: If Cooling Option is selected a perforated insert is required. Select Surround Material Same as Insert Austin Plus Vinyl Austin Cooper Vinyl Aberdeen Vinyl Allante Vinyl Monterey Leather Partners Leather Special Request Austin Plus Black Buff Truffle Sand Driftwood Medium Graph Platinum Austin Cooper Black Medium Graphite Ashes Sand Driftwood Truffle Ivory Buff Aberdeen Merlot Medium Alabaster Alabaster Pewter Chamois Fawn Latte Steerhide Chocolate Buckskin Lasso Allante Black Charcoal Gray White Sea Oyster Burgundy Wine Cinnamon Cream Bisque Parchment Pearl Grey Oxford Beachwood Light Sand Medium Gray Nu Royal Blue Hideaway Monterey Lt Camano Grey Lt Tan Med Camano Grey Black Medium Flint Graphite Partners Lt Parchment Black Black Ink Tan Lt Beige Grey Dk Grey Red Off White Snowstorm Bisque Spice Med Prarie Walnut Lt Grey Lt Graphite Dk Graphite Shale Lt SilverGrey Moondust Neutral Lt Parchment Very Dark Pewter Camel Ranch Tan Crimson Surround Special Request Surround Stitching Single Needle Double Needle Welt/Piping Welt Color Mono Tone Contrast Color Special Request Welt Contrast Color and Special Request Thread Color Mono Tone Contrast Color Thread Contrast Color back next Captain Chair Options Seat 1 & 2 Seat Frame Power Recline Manual Recline Recline Handle Location Aisle Wall Power Control Switch Options Mounted Loose Headrest Power Manual Seat Belt (3 PT Integrated) Black Beige Brown Light Gray Dark Gray Special Request Seat Belt Special Request Arm Rests Wall Aisle Dual None Arm Mounting Mounted Loose Power Leg Lift Scissor Lift Concealed Lift None Power Base 6 Way Power Base No Power Base The six-way base powers the chair forward/rearward, up/down, and tilt. Pedestal 6.5 inch fixed 6.5 inch swivel 10 inch fixed 10 inch swivel None We suggest a 6in. pedestal with a 6 way power base. For all other chairs we recommend a 10in. pedestal. Manual Slide Tracks Yes No Manual Slide Tracks not available if you have chosen Power Leg Lift. Lumbar Options Power Lumbar Manual Lumbar None Comfort Controls Heat w/Switch Cool w/Switch Massage w/Switch Heat/Cool/Massage w/Wand NOTE: If Cooling Option is selected a perforated insert is required. Extras Seat 1 & 2 Child Locks (CSRS Child Safety Restraint Systems) Yes No Logos on Headrest Yes No Upload Your Logo Here back next Captain Chair Options Seat 3 & 4 Identical Options to Seats 1 & 2 Yes Seat Frame Power Recline Manual Recline Power Control Switch Options Mounted Loose Headrest Power Manual Seat Belt (3 PT Integrated) Black Beige Brown Light Gray Dark Gray Special Request Seat Belt Special Request Arm Rests Wall Aisle Dual None Arm Mounting Mounted Loose Power Leg Lift Scissor Lift Concealed Lift None Power Base 6 Way Power Base No Power Base The six-way base powers the chair forward/rearward, up/down, and tilt. Pedestal 6.5 inch fixed 6.5 inch swivel 10 inch fixed 10 inch swivel None We suggest a 6in. pedestal with a 6 way power base. For all other chairs we recommend a 10in. pedestal. Manual Slide Tracks Yes No Manual Slide Tracks not available if you have chosen Power Leg Lift. Lumbar Options Power Lumbar Manual Lumbar None Comfort Controls Heat w/Switch Cool w/Switch Massage w/Switch Heat/Cool/Massage w/Wand NOTE: If Cooling Option is selected a perforated insert is required. Extras Seat 3 & 4 Child Locks (CSRS Child Safety Restraint Systems) Yes No Do You Want Logos on the Headrest (Click Here to Upload Your Logo) back next Captain Chair Options Seat 5 & 6 Identical Options to Seats 1 & 2 Yes Seat Frame Power Recline Manual Recline Power Control Switch Options Mounted Loose Headrest Power Manual Seat Belt (3 PT Integrated) Black Beige Brown Light Gray Dark Gray Special Request Seat Belt Special Request Arm Rests Wall Aisle Dual None Arm Mounting Mounted Loose Power Leg Lift Scissor Lift Concealed Lift None Power Base 6 Way Power Base No Power Base The six-way base powers the chair forward/rearward, up/down, and tilt. Pedestal 6.5 inch fixed 6.5 inch swivel 10 inch fixed 10 inch swivel None We suggest a 6in. pedestal with a 6 way power base. For all other chairs we recommend a 10in. pedestal. Manual Slide Tracks Yes No Manual Slide Tracks not available if you have chosen Power Leg Lift. Lumbar Options Power Lumbar Manual Lumbar None Comfort Controls Heat w/Switch Cool w/Switch Massage w/Switch Heat/Cool/Massage w/Wand NOTE: If Cooling Option is selected a perforated insert is required. Extras Seat 5 & 6 Child Locks (CSRS Child Safety Restraint Systems) Yes No Do You Want Logos on the Headrest (Click Here to Upload Your Logo) back next Captain Chair Options Seat 7 & 8 Identical Options to Seats 1 & 2 Yes Seat Frame Power Recline Manual Recline Power Control Switch Options Mounted Loose Headrest Power Manual Seat Belt (3 PT Integrated) Black Beige Brown Light Gray Dark Gray Special Request Seat Belt Special Request Arm Rests Wall Aisle Dual None Arm Mounting Mounted Loose Power Leg Lift Scissor Lift Concealed Lift None Power Base 6 Way Power Base No Power Base The six-way base powers the chair forward/rearward, up/down, and tilt. Pedestal 6.5 inch fixed 6.5 inch swivel 10 inch fixed 10 inch swivel None We suggest a 6in. pedestal with a 6 way power base. For all other chairs we recommend a 10in. pedestal. Manual Slide Tracks Yes No Manual Slide Tracks not available if you have chosen Power Leg Lift. Lumbar Options Power Lumbar Manual Lumbar None Comfort Controls Heat w/Switch Cool w/Switch Massage w/Switch Heat/Cool/Massage w/Wand NOTE: If Cooling Option is selected a perforated insert is required. Extras Seat 7 & 8 Child Locks (CSRS Child Safety Restraint Systems) Yes No Do You Want Logos on the Headrest (Click Here to Upload Your Logo) back next Please note any special requirements here for the build order (1000 chars left) back submit Thank you for your order. A customer service representative will be in contact shortly to discuss payment arrangements, shipping options and your total cost. Customer Service is available Monday through Friday from 9:00AM EST to 6PM EST. Please call 1 (855) 881-1800 if you have any questions. Order Another Chair? or Return Home Files submitted, sending form data now. Please do not abort!Please turn on javascript to submit your data. Thank you!
