Company Name:

Company Address:

Contact Person:

Mobile:

Your email:

Date:

Customer name:

Version:

1. Recliner Model Name/Number:

2. Seat Row Configuration: No of units-

Double ArmCommon Arm

Couple Recliner -

WITH Drop down ArmWITHOUT Drop down Arm

Arm Width -

14 cm20 cm

Seat Width -

57cmOther

If Customized size, plz specify

3. What Kind of Recliner?

ManualMotorized

4. Motors:

Single Motor (Leg & Back)Double Motor A (Leg & Back + Neck)Double Motor B (Leg + Back)Triple Motor (Leg + Back + Neck)Four Motor( Leg+Back+Neck+Lumbar)

Is Table Required?

YesNo

Integrated Cup Holder Table

YesNo

If answer yes,
Type kind of Table is required?

Double Swivel TableSwivel TableDetachable Tablein Arm Double Swivel Table

Table shape?

OvalRectangleTablet

Table colour?

BlackItalian Walnut Finish

Location of table

Right ArmLeft Arm

5. Upholstery

PVC (Faux Leather)Fabric - Molfino (Value)fabric - Warwick (Premium)Half Leather (50% leather & 50% PVC)Premium Leather

Upholstery Color:

6. Cup Holder

Stainless SteelBlack Normal CupholderChiller CupholderLed CupholderChiller Cupholder with Seat control Options

If you choose LED Cupholder what kind of LED Colour you need?

Blue/ Red/ Warm White/Green

7.Foot Light

If yes, please choose footlight LED colour, Blue/ Red/ Warm White/Green

8. Choose Recliner control switch type

2-way normal Switch2-way switch with USB2-way metal switch with USB4-way metal switch with USBNormal 2-way Metal SwitchTouch Panel

9. Reading Light

YesNo

10. Type of Plug Point. – please attach picture

11. Table B – Table between Recliners:

YesNo

a. Finish:

Wood VeneerLeather

b. Dimensions:

LxWxH

c. Lamp:

YesNo