Section [A]
Return Seat To: SEAT WILL BE
RETURN-SHIPPED "SIGNATURE REQUIRED." |
NAME:
(FIRST, MI, LAST)) |
|
COMPANY NAME:
(IF APPLICABLE) |
|
| APT or SUITE
#:: |
|
STREET
ADDRESS:
No PO Boxes Please! |
|
| CITY, ST, ZIP |
|
DAYTIME PHONE:
REQUIRED |
|
EMAIL ADDRESS:
We will email shipping
confirmation, if desired. |
|
| Type
of Motorcycle (Please supply exact
year, make, model, and cc.) |
| Year: |
|
| Make: |
|
| Model: |
|
| CC’s: |
|
| Colors (Optional): |
|
Custom Services Order Form - Instructions
Use this form when sending a seat for custom services or upholstery product installation.
SECTION A
1. Fill out section [A] of
the order form. No Post Office Boxes Please! We can only return your seat to a street
address.
Year, Make, Model, Engine Type and CC size is vital.
And, DAYTIME phone number is critical if we have questions.
PLEASE DON’T
FORGET TO ATTACH THIS ORDER FORM AND ANY SPECIAL INSTRUCTIONS TO THE SEAT!
Sargent Cycle Products
North America
1036 Hubbard Street Jacksonville, FL 32206 • 1-800-749-7328 / 904 354-4531 • FAX
904-354-7979 • www.SargentCycle.com
Section [B]
| Base Price
(See Base Price Table) |
|
Upholstery
Inserts - Black Only (check one):
[ ] Pleated Vinyl (no charge) [ ] CarbonFX
vinyl (add $20.00)
[ ] Smooth Vinyl (no charge)
[ ] Button Fit (add $25.00)
[ ] Leather (non-refundable),
please call
NOTE: Smooth color vinyl is available as an extra option for an additional charge. |
|
Upholstery
Seams (check one):
[ ] Topstitch (flat seam)
[ ] Standard Black Welt (Piping)
[ ] Colored Welt (add $20.00)
Regarding color, please call to request a color vinyl sample kit
from which to make your choice. |
|
| Extra
Options - List any other
options that you wish to apply and the applicable charges (see the Custom Seat Services
Price List): |
|
| |
|
| |
|
| |
|
|
|
Please
review IMPORTANT information about your seat's LEVEL LINE! |
|
Return Shipping and Handling* (FedEx Ground Continental USA only) |
$19.95 |
Limited USPS Service is available for Military Addresses
Only - $40.00
*Additional Shipping Charges may apply to large touring seats, oversized seats,
shipping to Alaska/Hawaii or outside the continental United States - CALL FOR PRICE. |
|
Sub-Total (Florida
Residents - add local county sales tax) |
|
TOTAL |
|
SECTION B
2. Next, check the bottom
of your seat to determine the type of seat pan you have (plastic, metal, fiberglass, or
aftermarket), and if it’s a one-piece or two-piece pan. Refer to the Base Price Table
and enter the appropriate price in section [B] of the order form.
3. Review the Upholstery and Extra
Options section of the Custom Seat Services Price List and
enter any choices in section [B] of the order form. Also, if foam alterations are called
for, enter those choices from the Foam Alteration Guide or the
Custom Seat Services Price List, and total the column.
For easier reference - you may want to print these price lists.
PLEASE DON’T
FORGET TO ATTACH THIS ORDER FORM AND ANY SPECIAL INSTRUCTIONS TO THE SEAT!
Section [C]
| Method of Payment |
| [ ] Money Order [ ]
Personal Check (NOTE: Will be held
for 11 days.) |
| Credit Card: [ ] Discover
[ ] MasterCard [ ] VISA |
| Credit
Card #: __ __ __ __ - __ __ __ __ - __ __ __ __ - __ __ __ __ |
| CSS or CVC
# (Back of card): __ __ __ Three digits |
| [ ] American Express |
| AMEX Card
#: __ __ __ __ - __ __ __ __ __ __ - __ __ __ __ __ |
| CSS or CVC
# (Front of Card): __ __ __ __ Four digits |
| Expiration Date: __ __ /
__ __ (FOR ALL CARDS) |
| Name (as it appears on
the card): |
| Authorized Signature: |
If Different Than
Shipping Address:
Billing Address: |
| City, ST, ZIP: |
| Home Phone: |
SECTION C
4. Complete the Method of
Payment in section [C] (on back of order form).
5. Attach the order
form and any special instructions to the seat. Box up the seat and ship to:
Sargent Cycle Products, 1036 Hubbard Street, Jacksonville, FL 32206.
NOTE: It should be inexpensive to ship
your seat by ground transportation, especially if you box it yourself and take it to a
U.P.S. or U.S. Post Office outlet (call in your area).
Packing and shipping companies are more convenient, but charge accordingly.
IMPORTANT NOTE: Use of this form constitutes acceptance of the Custom Foam Alteration Policy
and the Custom Seat Services Warranty.
Sargent Cycle Products
North America
1036 Hubbard Street Jacksonville, FL 32206 • 1-800-749-7328 / 904-354-4531 • FAX
904-354-7979 • www.SargentCycle.com |