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:

Closing Style

•Ramps only included on specified platforms
•Aluminum Retention Ramp (ARR)

Platform Sizes

       Platform Width is:
       90" for 96" Wide Bodies
       96" for 102" Wide Bodies

For RC-2:

For RC-3 and RC-4:

For RC-5 and RC-6:

For RC-CS-3:

For RC-CS-4:

Ramp Options

Ramp for 42"

Ramp for 48"

Ramp for 60"
(Both Splits)

Ramp for 72"
(42" + 30")

Standard Options

Auxiliary Hand Pump - Cam Closure
Auxiliary Hand Pump - Hydraulic Closure
Hydraulic Platform Closer
Removable Liftgate Option
Removable Fixture
Street Side Control
Hand Held Coiled Remote Control For Cam Closure
Hand Held Coiled Remote Control For Hydraulic Closure
Cab Power Cutt Off Switch
Low Voltage Thermal Switch
Circuit Breaker (150 Amp)
Batteries For Trailer Paks (HD Deep Cycle 6 Volts)
Battery Box for HD Deep Cycle 6 Volt Batteries (Batteries not included)
Battery Box with HD Deep Cycle 6 Volt Batteries (Batteries are installed at factory)
Dual Pump & Motor Assembly for Cam Closer Only

Trailer Paks Click Here For More Information

RC Trailer Pak I - Single Pole
RC Trailer Pak I - Dual Pole
RC Trailer Pak II - Single Pole For 6 Volt
RC Trailer Pak II - Single Pole For 12 Volt
RC Trailer Pak II - Dual Pole For 6 Volt
RC Trailer Pak II - Dual Pole For 12 Volt
RC Trailer Pak III - Single Pole For 6 Volt
RC Trailer Pak III - Single Pole For 12 Volt
RC Trailer Pak III - Dual Pole For 6 Volt
RC Trailer Pak III - Dual Pole For 12 Volt

Tractor Pak Options Click Here For More Information

Tractor Kit 1-Single Pole
Tractor Kit 2-Dual Pole
Tractor Kit 3-Dual Adapter