Order Form

Upon receipt of this order, confirmation and pricing will be returned to the sender's address. Please contact Customer Service at 1-800-227-4116 or email us at cservice@maxonlift.com with any questions. Thank you for choosing MAXON.

Note: Fields with " * " must be filled.

Maxon Account #:

*Company Name:

*Contact Name:

*Telephone #:

( ) -

*Email:

Check if you do not have an email address

*P.O. #:

Date:

/ /

Billing Address:

*Company Name:

*Address:

*City:

*Country:

*Province/State:

*Postal/Zip Code :

Ship To:

Check if same as Billing Address

*Company Name:

*Address:

*City:

*Country:

*Province/State:

*Postal/Zip Code :

Shipping Instructions

•In the spaces below, please provide the name and phone number of your preferred carrier.

•To ship via Maxon's common carrier, leave those spaces BLANK. The freight charges will be included on your price confirmation.

Carrier Name:

Carrier Telephone #:

*Required Ship Date:

/ /

Required In-House Date:

/ /

Additional Delivery Instructions:

Quantity:

Vehicle Type :

Body Width :

Model:

Platform for GPC-33:

Platform for GPC-44:

Platform for GPC-55:

Standard Options

Aluminum and Custom Platforms
Dual Cart Stop
Forklift Crossover Option
Flip-Up Door with Full Seal Kit
Auto Leveling with Foot Controls
Narrow Body Ref: 2 Meters or 79" Wide Bodies
Hand Held Remote Control
Cab Power Cut Off Switch
Low Voltage Thermal Switch
Circuit Breaker Kit (150 Amp
Battery Box for HD Deep Cycle 6 Volt Batteries (Batteries Not Included)
Battery Box for HD Deep Cycle 6 Volt Batteries Installed

Trailer Pak Options Click Here For More Information

Trailer Kit A (Single Pole)
Trailer Kit A (Dual Pole)
Trailer Kit B (Single Pole)
Trailer Kit B (Single w/Batteries)
Trailer Kit B (Dua Pole)
Trailer Kit B (Dual w/Batteries)
Auxiliary Battery Box
Tractor Kit 1-Single Pole
Tractor Kit 2-Dual Pole
Tractor Kit 3-Dual Adapter