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Bespoke Glass Quotation Form HEAD OFFICE AND FACTORY Aquavision Unit 7 Riverpark, Billet Lane Berkhamsted, Hertfordshire HP4 1HL United Kingdom +44 [0]1442 872665 AMERICAN OFFICE Aquavision, Inc. #197 5 Southside Drive, Suite 11 Clifton Park, NY 12065 America +1 800 524 1804 Aquavision Distribution Ltd. is a company registered in England and Wales. Registered number: 07756677 IMPORTANT – All dimensions shown are from the front of the mirror. Use one form for each piece of glass required. Once you have completed the form please email it to [email protected]. To be able to give an accurate price, we will need the following information: A Mirror Height B Mirror Width C Distance BOTTOM of TV to BOTTOM of mirror, or Central D Distance LEFT side of TV window to LEFT side of mirror, or Central E TV Screen size 16”, 22”, 27”, 32”, 42”, 55”, 65”, 85” or leave BLANK for matching mirrors. [55”, 65”, 85” are Elite 4K only] TV Model Genesis, Nexus, Pinnacle, ConnecTV/ConnecTV Active, Elite 4K. Glass Type MirrorVision+ ® or painted to RAL No. Dimensions Please indicate unit of measurement Accessories AVF-5SPEAKERS Stereo Ceiling speaker AVF-4SPEAKERS Ceiling speaker AVF-3SPEAKERS Ceiling speaker AVF-2SPEAKERS Surface speaker AVF-1SPEAKERS Surface speaker AVF-5RSP Remote Switch Panel AVF-4SKYA Sky Remote Eye Kit AVF-IRBLAST Infrared Blaster AVF-SRLYF Relay Interface Module Completed by: Company: Date: Phone No: Email: Notes: ¨ Aquavision’s MirrorVision+ is the standard Mirror glass supplied ¨ Dimensions C and D are not required for initial quotation ¨ Aquavision only supply mirrors or custom glass for installation with Aquavision televisions ¨ Glass is generally ready for collection 6 weeks from confirmed order ¨ Mounting brackets may be suggested but it’s the customer’s responsibility to ensure these, and any fixings, are correct for the job ¨ Maximum size 2400mm x 1500mm or 94” x 60” ¨ Glass is 6mm [1/4”] thick Aquavision use only. Quote Reference ______________ Drawing Reference 4009-_________________ REV __________ Issued for Manufacturer _____ /_____ /_____ Expected delivery ____ /____ /____ Account Reference _________ ____PO#_______________ SO#___________ Delivered ____ /_____ /_____ Any special requirements [holes for cables, lights, taps, Bevels etc]: Signed: PLEASE NOTE: Please tick the box to agree use of the signature above. Tel: +44 (0)1256 638500 Sales email: [email protected]

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Bespoke Glass Quotation Form

HEAD OFFICE AND FACTORY Aquavision Unit 7 Riverpark, Billet Lane Berkhamsted, Hertfordshire HP4 1HL United Kingdom +44 [0]1442 872665

AMERICAN OFFICE Aquavision, Inc.

#197 5 Southside Drive, Suite 11

Clifton Park, NY 12065 America

+1 800 524 1804

Aquavision Distribution Ltd. is a company registered in England and Wales. Registered number: 07756677

IMPORTANT – All dimensions shown are from the front of the mirror. Use one form for each piece of glass required.Once you have completed the form please email it to [email protected].

To be able to give an accurate price, we will need the following information:

A Mirror Height

B Mirror Width

C Distance BOTTOM of TV to BOTTOM of mirror, or Central

D Distance LEFT side of TV window to LEFT side of mirror, or Central

E TV Screen size 16”, 22”, 27”, 32”, 42”, 55”, 65”, 85” or leave BLANK for matching mirrors. [55”, 65”, 85” are Elite 4K only]

TV Model Genesis, Nexus, Pinnacle, ConnecTV/ConnecTV Active, Elite 4K.

Glass Type MirrorVision+® or painted to RAL No.

Dimensions Please indicate unit of measurement

Accessories

AVF-5SPEAKERS Stereo Ceiling speaker

AVF-4SPEAKERS Ceiling speaker

AVF-3SPEAKERS Ceiling speaker

AVF-2SPEAKERS Surface speaker

AVF-1SPEAKERS Surface speaker

AVF-5RSP Remote Switch Panel

AVF-4SKYA Sky Remote Eye Kit

AVF-IRBLAST Infrared Blaster

AVF-SRLYF Relay Interface Module

Completed by:

Company:

Date:

Phone No:

Email:

Notes:

¨ Aquavision’s MirrorVision+ is the standard Mirror glass supplied

¨ Dimensions C and D are not required for initial quotation

¨ Aquavision only supply mirrors or custom glass for installation with Aquavision televisions

¨ Glass is generally ready for collection 6 weeks from confirmed order

¨ Mounting brackets may be suggested but it’s the customer’s responsibility to ensure these, and any fixings, are correct for the job

¨ Maximum size 2400mm x 1500mm or 94” x 60”

¨ Glass is 6mm [1/4”] thick

Aquavision use only.

Quote Reference ______________ Drawing Reference 4009-_________________ REV __________ Issued for Manufacturer _____ /_____ /_____

Expected delivery ____ /____ /____ Account Reference _________ ____PO#_______________ SO#___________ Delivered ____ /_____ /_____

Any special requirements [holes for cables, lights, taps, Bevels etc]:

Signed: PLEASE NOTE: Please tick the box to agree use of the signature above.

Tel: +44 (0)1256 638500

Sales email: [email protected]