Date: ____________________________ Date Requested: ____________________

Name: ________________________________________________

Address: _______________________________________________

Phone Number: (where you can be reached): _________________________

Rider Information:

Weight:_______________________________________ Class: _________________

Types of Riding/Track Conditions: _________________________________________

Machine Information: (Information provided is very important)

Year: __________ Make: __________ Model: __________ 2 or 4 stroke: __________

Current Suspension Conditions: (Please circle one)

Stock Ridden    Stock Unridden    Modified    Damaged

Current suspension problems and or complaints: _________________

______________________________________________________

If modified, by who? ______________________________________

Service Check List: Check the services you require

O       Front Fork Rebuild: $112.95 plus parts*

O       Front Fork parts and oil: $TBD

O       Front Fork Revalve: $175 plus parts*

O       Front Fork Springs: $110.00 ($112.00 for showa)

O       Rear Shock Rebuild: $90 plus parts*

O       Rear Shock parts and oil: $TBD

O       Rear Shock Revalve: $175 plus parts*

O       Rear Shock Springs: starting at $98 ($122 for showa)

O       Rear Shock WiigStyle Bladder Cap: $35

O       ATV Front Shocks Rebuild: $70 plus parts* Long-travel front: $80

O       ATV Front Shock parts and oil: $TBD

O       ATV Rear Shock Rebuild: $60 plus parts* Long-travel rear: $70

O       ATV Rear Shock parts and oil: $TBD

O       ATV Front Shock Revalve: $175 plus parts*

O       ATV Rear Shock Revalve: $175 plus parts*

O       Polaris Outlaw Riders add $60 for additional rear shock if not irs model.

Price  Quoted: _____________________________________

Authorizing Signature: ________________________________