Price List and Order Form

Customer Information

Name:
Address:
City:State:Zip Code:
Phone with Area Code: Fax:

Method of Payment:CheckVisa or Mastercard
Credit Card Number:
Expiration Date:

CRUISERLIFT Motorcycle Lift for RV's

MOTOR COACH INFORMATION:

Manuf. Year: Motor Coach Manufacture: Coach Model:

Class-A Diesel: Class-A Gas: Motor Coach Length:Ft

Trailer plug style on the rear of coach: 4-Wire Flat: 6-Pole Round: 6-Pole Rectangular: 7-Blade Round:

Distance from the rear of the motor coach to the location of the house batteries: Ft (This distance is needed to assure the proper length of power lead from the winch switch to the battery)

Part Number	Description	Qty	Price
71007-1	Single Motorcycle Lift, for RV's - Heavy Duty with electric winch and double cable/pulley wrap.		$2,779.

Total Cost

LIFT COST

CA Residents Add Local Sales Tax

Crate Charge
FREE

Shipping

Total Cost

There are 3 ways to submit your order,

Print a copy of this form and FAX to 530.432.7751, or
Print a copy and mail to the address below, or
Call us at 800.828.8281, or 530.432.7758

LIFT COST
CA Residents Add Local Sales Tax
Crate Charge	FREE
Shipping
Total Cost