Ultimate Order Form
Partner Details
Surveyor or Partner Contact Name
Date
Partner Order Reference
Partner Business Name
Fulfilment Method
Delivery
Collection
Install Only
Install & Maintenance
Delivery Address
Postcode
Telephone
User and Usage
Estimate number of trips per day (Optional)
Ensure all measurements are entered in millimetres.
1m = 1000mm.
A
mm
B
mm
C
mm
D
mm
Weight
kg
Height
mm
Minimum Seat Width
mm
Disability/Condition (Optional)
Product Options
Model
Platinum Ultimate (120kg/19st)
Platinum Ultimate Heavy Duty (160kg/25st)
Platinum Ultimate Rail Only (120kg/19st)
Platinum Ultimate Rail Only Heavy Duty (160kg/25st)
Seat Swivel Option
Manual
Power
Additional Remote Quantity
Intermediate Charge Points
Please mark any extra charge points on the drawing you provide.
1st
Charge Point Location - Step Number
Add Charge Point
User Facing Direction
Upward
Only compatible with power swivel. Not available with first step start.
Downward
Only compatible with power swivel.
Sideward
Rail Colour
RAL 9002 Standard
RAL Other
If other please specify:
Underfloor Heating
No
Yes - Lower Level
Yes - Upper Level
Upholstery Colour
Beige
Red
Blue
Grey
Black
Rail Position on Staircase
Select rail position (from bottom of staircase looking up)
Left Hand External
Rail on outer wall
Right Hand Internal
Rail on inner wall
Left Hand Internal
Rail on inner wall
Right Hand External
Rail on outer wall
Bottom of Staircase
Rail Start
Standard
First Step
Overrun
A
mm
(Min 500mm)
B
mm
(Distance to obstruction)
Bottom of Staircase Rail Position
Standard
90° Wrap
Other
°
180° Wrap
Other
°
Top of Staircase
Rail Finish
Standard 100mm Overrun
Reduced Intrusion 0mm
Overrun
A
mm
(Min 100mm)
B
mm
(Distance to obstruction)
Top of Staircase Rail Position
Standard
90° Wrap
Other
°
180° Wrap
Other
°
Staircase Measurements
Survey Type
Manual
Digital
Number of Risers
1st Riser Height (a)
Vertical Height (b)
Horizontal Length (c)
Nose to Nose (d)
Angle (e)
Narrowest Width (f)
Stringer Width (g)
1st Flight
Number of Risers
1st Riser/Step Height (a)
mm
Vertical Height (b)
mm
Horizontal Length (c)
mm
Nose to Nose (d)
mm
Angle (e)
°
Narrowest Width (f)
mm
Stringer Width (g)
mm
Add Flight
Total Number of Risers
Number of risers in entire staircase
Total Height Measured
Staircase height from floor to top riser
mm
Measurements Validation
Pythagoras from previous measurements.
1st Flight
Calculated Nose to Nose (D)
mm
Average Rise
mm
Average Go/Tread
mm
Add Flight
Bulkhead Measurements
Overhead Height Restrictions
1st Riser
Height (H)
mm
Offset (O)
mm
Add Riser
Upload a Sketch/Drawing
All drawings and measurements assumed to be taken to stringer (unless specified).
Additional Information
Notes/Special Instructions (Optional)
I have read and agree to the
Terms and Conditions
and confirm that the information I have provided is accurate and complete.
Date