AC Voltmeter 0-150V

Analog Meter 2 Rocker Circuit Breaker 10

10A 0532

0328

0185

0266

10A

10A

10A

Access Lights

Night Lights

Fire AlarmHolding Tank Alarm

1

Label Number

Current Rating

Label Text

4a

5

Use the Panel Layout Grid to record all module and component details required for your custom panel.

1. DRAW A BOX INDICATING THE PANEL FRAME SIZE AND ORIENTATION YOU WANT. ChoosefromtheselectionofpanelframesizesandorientationsillustratedonPanel Frames Table—page3.

2. ON THE PANEL LAYOUT GRID, WRITE IN THE VOLTAGE RATING REQUESTED IN THE SPACE PROVIDED.

3. ON THE PANEL LAYOUT GRID, WRITE THE MODULE NAME AND NUMBER IN THE SPACE PROVIDED. Choosefromtheselectionofmodulesillustratedon360 Panel Modules—page4.

4. FOR CIRCUIT BREAKER MODULES, WRITE IN THE SPACE PROVIDED: a. The current rating for each circuit Choosefromthecurrentratingslistedunderthemoduleson360 Panel Modules—page4. b. The label number and label text for each circuit Choosefromover500StandardlabelslistedonStandard Label List—pages5and6,orfill outtheCustom Label Order Form—page7and8.

5. FOR ALL OTHER MODULES, INDICATE MODULE PLACEMENT AND SPECIFY THE COMPONENTS TO BE INSTALLED.

When all modules and components of your panel are recorded clearly on the

Panel Layout Grid—page 2, please fax to (360)734–4195

Within 3 business days you will receive a price quote, and an estimated delivery date.

Page 1 of 8

Panel Layout Grid Worksheet Example

Custom 360 Panel Worksheet—Instructions

Module Name

Module Number 2

4b

990343360 Rev. 005

12 Volts DC120 Volts AC

Voltage Rating3

1. Select circuit breaker style. FlatRocker RestrictedOFFRocker BlackToggle WhiteToggle IndicateexceptionsatdesiredcircuitbreakerlocationsonthePanelLayoutGridbelow.

2. Select DC voltage if your panel includes DC circuits. 12V 24V

3. Select AC voltage if your panel includes AC circuits. 120V 230V 120/240V

Page 1 of 8 Page 2 of 8

Recordotherpaneldetailsincludingwiring:

Contact

Company

Mailingaddress

Phone Fax

E-mail

Datesubmittedbycustomer

PleaseFAXcompletedworksheetto:(360)734–4195

Phone:(360)738–8230E-mail:conductor@bluesea.com

Reviewedby

Datereviewed

Custom 360 Panel Worksheet—Panel Layout Grid

16

3⁄4

" (426m

m)

43⁄4

" (121m

m)

73⁄4

" (197m

m)

10

3⁄4

" (273m

m)

13

3⁄4

" (349m

m)

47⁄8"(124mm) 91⁄4"(235mm) 135⁄8"(346mm) 18"(457mm) 223⁄8"(568mm)

PanelFrames

Height in"(mm)

Width in"(mm)

1×1

43⁄4(121) 47⁄8(124)

1×2

43⁄4(121) 91⁄4(235)

1×3

43⁄4(121) 135⁄8(346)

1×4

43⁄4(121) 18(457)

2×1

73⁄4(197) 47⁄8(124)

2×2

73⁄4(197) 91⁄4(235)

2×3

73⁄4(197) 135⁄8(346)

2×4

73⁄4(197) 18(457)

3×1

103⁄4(273) 47⁄8(124)

3×2

103⁄4(273) 91⁄4(235)

PanelFrames

Height in"(mm)

Width in"(mm)

3×3

103⁄4(273) 135⁄8(346)

3×4

103⁄4(273) 18(457)

3×5

103⁄4(273) 223⁄8(568)

4×1

133⁄4(349) 47⁄8(124)

4×2

133⁄4(349) 91⁄4(235)

4×3

133⁄4(349) 135⁄8(346)

4×4

133⁄4(349) 18(457)

4×5

133⁄4(349) 223⁄8(568)

5×2

163⁄4(426) 91⁄4(235)

Custom 360 Panel Worksheet—Panel Frames Table

Page 3 of 8990343360 Rev. 005

4. Vessel Systems Monitor VSM422†

Vessel Systems Monitor VSM422:• Four meters in one: ACMultimeter,DCMultimeter, TankMeter,BilgeMeter• Complete monitoring of 4 critical functions with 22 measurements identifying problems before they become emergencies

† Available second quarter 2008

6. DC Push Button Circuit Breaker

Push Button Reset-Only Circuit Breakers:3A,4A,5A,7A,10A,12A,15A,20A,25A,30A,35A,40A

15

15

15

15 15

15

15

15

9. DC m-Series Battery Switch

m-Series Battery Switches: (availableinredorblack)• Single Circuit with Key • Single Circuit with Knob• Selector• Dual Circuit™ • Dual Circuit Plus™

8. Remote Control Panels†

Features:• Remote Battery Switch*—lowampswitching• Automatic Charging Relay*—combinesbatteriesforcharging• Manage dual battery—oneengine• Manage triple battery—twoengines

† Available second quarter 2008* Not included

3. Analog DIN Meter

Meters:• DC Voltmeters: 8–16V,18–32V• DC Ammeters: 0–25A,0–50A,0–100A,0–150A

• AC Voltmeters: 0–150V,0–250V• AC Ammeter: 0–50A

2. Analog Meter

Meters:• DC VoltmetersA:8–16V,18–32V• DC Ammeters:0–25A,0–50A,0–75A,0–100A,0–150A,0–200A• DC Zero Center Ammeters: 50–0–50A,100–0–100A

• AC VoltmetersB: 0–150V,0–250V• AC AmmetersB: 0–50A,0–100A

SWITCHES:A Included: 3DCSources, B Optional: ACLoadGroups

AC VOLTS

012525

50 75 100

150

1. Digital Meter

Meters:• DC Voltmeter A: 0–60V• DC Voltmeter w/Alarm A: 0–60V• DC Ammeter: –500–500A• DC Multimeter w/Alarm A: –500–500A/0–60V

• AC Voltmeter B: 80–270V• AC Ammeter B:0–150A• AC Frequency Meter: 40–90Hz• AC Multimeter w/Alarm B:0–150A,80–270V,0–35kW,40–90Hz

SWITCHES:A Included: 3DCSources, B Optional: 2ACLoadGroups

SETMENU

V

A 2.88

10. Rocker Circuit Breaker

Flat or Restricted OFF Rocker Circuit Breakers:• DC Single Pole: 5A,8A,10A,15A,20A,25A,30A,40A,50A, 60A,80A,100A• DC Double Pole: 150A,175A,200A• DC Triple Pole: 250A,300A

• AC Single Pole: 5A,8A,10A,15A,20A,25A,30A,40A,50A• AC Double Pole: 10A,15A,16A,20A,30A,32A,40A,50A, 60A,80A,100A• AC Triple Pole: 50A,60A,80A,100A

11. Toggle Circuit Breaker

Black or White Toggle Circuit Breakers:DC Single Pole: 5A,8A,10A,15A,20A,25A,30A,40A,50A

AC Single Pole: 5A,8A,10A,15A,20A,25A,30A,40A,50AAC Double Pole: 10A,15A,16A,20A,30A,32A,40A,50A

12. AC Lockout Slide Source Selector

Raised Rocker and Black Toggle Circuit Breakers:120 Volts:30A,50A

230 Volts: 16A,32A

120/240 Volts (NOT SHOWN): 50A,60A,80A,100A (Requires 2 modules in a column)

16. Blank 17. 12 Volt Sockets

• Blank—usedtomountaccessories• 12 Volt Sockets—15Aratingpersocket

15. AC Rotary Switch Source Selector

Rotary Switches:• 30A: 2position+Off,4Pole• 30A: 2position+Off,2Pole• 30A: 3position+Off,2Pole

• 65A: 2position+Off,2Pole• 65A: 2position+Off,3Pole• 65A: 2position+Off,4Pole• 65A: 3position+Off,3Pole

14. AC Residual Current Circuit Breaker

RCBO/ELCI/GFCI:120 Volt, •15A,1Pole,5mAgroundfaulttripcurrent•30A,2Pole,30mAgroundfaulttripcurrent

185 Series Circuit Breakers:25A,30A,35A,40A,50A,60A,70A,80A,90A,100A,110A,120A,135A,150A

13. 185 Series Circuit Breaker

7. DC Circuit Breaker + Rocker Switches

Push Button Reset-Only Circuit Breakers:3A,4A,5A,7A,10A

Rocker Switches:SPST: ON-OFFA,(ON)-OFFA

SPDT: ON-OFF-ONB,ON-OFF-(ON)B,(ON)-OFF-(ON)B

DPST: ON-OFFC,ON-ONC

DPDT:ON-(ON)C,ON-OFF-ONC,ON-OFF-(ON)C,(ON)-OFF-(ON)C

OPTIONAL SWITCHES:A 10A Max@12V and 24V DC B 10A Max@12V DC, 8A Max@24V DCC 5A Max@12 V and 24V DC

5. Gauge (DPDTSwitchIncluded)

• Engine Temp: 100-250°F• Water Pressure: 0-30PSI/kPa• Oil Pressure: 0–80PSI/Bar• DC Voltmeter: 10–16V• DC Ammeter: 60–0–60A• Battery Condition

• Fuel level• Tank Level• Potable Water Level• Hourmeter• Clock Analog

Senders: 1) Tank Level: 8-16"tankdepth,14-24"tankdepth2) Engine Temperature: 1/8"input3) Oil Pressure: 80PSI,1/8"input

Gauges:

Custom 360 Panel Worksheet—360 Panel Modules

Page 3 of 8 Page 4 of 8990343360 Rev. 005

Label No. Label Text

1 #12 #23 (BLANK)5 12VOLTDC499 12VOLTOUTLETSINSIDE500 12VOLTOUTLETSOUTSIDE516 120/240V60HZ517 120/240V60HZSHOREPOWER502 120V60HZSHOREPOWER7 120VAC/60HZ6 120VACOUTLETS4 12VDCOUTLETS526 230VAC/50HZ10 24VOLTDC460 240VAC/60HZ8 240VOLTSAC9 24VDCOUTLETS468 250VAC/50HZ515 250V50HZSHOREPOWER462 ACBUS111 ACCOMPRESSOR12 ACFAN13 ACMAIN17 ACSUBPANEL14 ACPANEL15 ACPOWER16 ACREFRIGERATOR532 ACCENTLIGHT18 ACCESSORY19 ADF20 AERATOR21 AFTCABIN22 AFTCABINLIGHTS23 AFTCABINOUTLETS536 AFTCABINSUMP530 AFTDISCHARGEPUMP24 AFTHEAD25 AIRCOMPRESSOR26 AIRCONDITIONER27 AIRCONDIT228 AIRCONDIT329 AIRCONDIT430 AIRCONDITPUMP31 AIRHORN544 ALARM32 ALARMSYSTEM33 ALTDISCONNECT461 ALTERNATOR34 AMPLIFIER35 ANCHORLIGHT36 ANCHORLIGHTMAIN37 ANCHORLIGHTMIZZEN38 ANCHORWASHDOWN39 APPLIANCES40 ARCHLIGHTS41 AUDIO/VIDEOSYSTEM525 AUTOFILL43 AUTO-PILOT555 AUTO/MAN42 AUTO/MANUAL524 AUTOMATICCHARGINGRELAY44 BAITPUMP45 BAITWELL46 BALLASTCONTROLS47 BALLASTPUMP48 BAR481 BATHROOM49 BATTERY473 BATTERY1474 BATTERY250 BATTERYCHARGER51 BATTERYCHARGER2

52 BATTERYCOMPARTMENT53 BATTERYPARALLEL560 BATTERYSWITCH54 BEACON480 BEDROOM485 BEDROOMSLIDEOUT55 BILGE56 BILGEALARM57 BILGEALARM258 BILGEALARM359 BILGEALARM460 BILGELIGHTS61 BILGEPUMP62 BILGEPUMP263 BILGEPUMP364 BILGEPUMP4453 BILGEPUMPON-OFF-AUTO65 BLOWER66 BOATDAVIT67 BOOMLIGHT68 BOWLIGHT69 BOWTHRUSTER70 BRIDGE71 BRIDGEINST72 BRIDGELIGHTS73 BRIDGEOUTLETS74 CABIN75 CABIN2501 CABIN2FAN76 CABIN2LIGHTS77 CABIN2OUTLETS78 CABIN379 CABIN3LIGHTS80 CABIN3OUTLETS81 CABIN482 CABIN4LIGHTS83 CABIN4OUTLETS84 CABINFAN85 CABINHEATER86 CABINLIGHTS87 CABINOUTLETS88 CABLEMASTER89 CASSETTEPLAYER90 CBRADIO91 CCTV92 CDPLAYER93 CELLULARPHONE537 CENTERLIVEWELL94 CHARGER/INVERTER95 CHARTLIGHT96 CHARTPLOTTER97 CHOKE98 CIRCULATORPUMP508 CLOCK99 CLOSETLIGHT100 COCKPITLIGHTS101 COCKPITREFRIGERATOR102 COLORSOUNDER103 COMMELECTRONICS104 COMPARTMENTHEATER105 COMPARTMENTLIGHT106 COMPASSLIGHT107 COMPUTER514 COMPUTERDISPLAY108 CONDENSERPUMP109 CONSOLELIGHT110 CONVERTER111 COOKINGGRILL112 COOKTOP113 COOLINGPUMP114 COURTESYLIGHTS115 CREWLIGHTS

116 CREWQUARTERS117 DAVIT119 DCMAIN122 DCSUBPANEL118 DCLIGHTS120 DCOUTLETS121 DCREFRIGERATOR123 DECK124 DECKLIGHTS125 DECKLIGHTSAFT126 DECKLIGHTSFWD127 DECKLIGHTSPORT128 DECKLIGHTSSTBD129 DEFROSTER130 DEPTHRECORDER131 DEPTHSOUNDER132 DEPTH/SPEED133 DESALINATOR134 DIMMER135 DININGAREALIGHTS136 DININGAREAOUTLETS137 DISCHARGEPUMP138 DISHWASHER139 DISPOSAL140 DIVECOMPRESSOR141 DOCKINGLIGHTPORT142 DOCKINGLIGHTSTBD143 DOCKINGLIGHTS144 DOWNRIGGER145 DRYER146 DUMPVALVES566 ECU148 ELECTRONICS469 ELECTCONTROLUNIT147 ELECTRICHATCH150 EMERGENCYLIGHTS151 EMERGENCYPUMPS149 EMERG.BACKUPSYSTEM547 ENG1/ENG2152 ENG.RM.BILGEALARM157 ENG.RM.PANELMAIN545 ENGINE158 ENGINEALARM159 ENGINEBLOCKHEATER160 ENGINECONTROLPORT161 ENGINECONTROLSTBD162 ENGINECONTROLS163 ENGINEDRIVENREFRIG164 ENGINEEXHAUSTFAN165 ENGINEHATCH166 ENGINEHEATERPORT167 ENGINEHEATERSTBD168 ENGINEINST169 ENGINEOILPANPUMP153 ENGINEROOMBLOWER154 ENGINEROOMHEATER155 ENGINEROOMLIGHTS156 ENGINEROOMOUTLETS170 ENGINESHUTDOWN171 ENGINETEMP546 ENGINES172 ENTERTAINMENTCENTER173 ENTRANCEDOOR174 ENTRYSTEP175 EXHAUSTFAN176 EXHAUSTTEMP177 EXTERIOR178 EXTERIORLIGHTS179 FAN180 FAN2181 FAN3182 FAN4

183 FAX184 FILLINGPUMP185 FIREALARM186 FIREEXT187 FIREHORN459 FISHFINDER538 FISHBOXDRAIN188 FISHBOXICEMAKER520 FISHBOXPUMP521 FISHBOXREFRIG189 FISHINGLIGHT487 FISHWELLPUMP488 FISHWELLPUMP2190 FLOODLIGHTS191 FLOSCAN192 FLYBRIDGE193 FLYBRIDGEELECTRONICS194 FLYBRIDGELIGHTS195 FLYBRIDGEOUTLETS196 FOGLIGHTS197 FOREDECKLIGHT539 FORWARDBILGE198 FREEZER199 FRESHWATER200 FRESHWATERPUMP201 FRESHWATERPUMP2202 FRESHWATERPUMP3203 FRESHWATERPUMP4204 FRESHWATERWASH482 FRONTSLIDEOUT561 FUELGAUGE205 FUELPRIMERPUMP206 FUELPUMP207 FUELPUMP2208 FUELPUMP3209 FUELPUMP4210 FUELTANKHEATER211 FUELTRANSFER507 FUMEDETECTOR212 FURLERJIB213 FURLERMAINSAIL214 FURLERSPINNAKER215 FURNACE216 FWDCABIN217 FWDCABINLIGHTS218 FWDCABINOUTLETS529 FWDDISCHARGEPUMP528 FWDHEAD219 GALLEY220 GALLEYAPPLIANCES221 GALLEYDRAIN222 GALLEYFAN223 GALLEYLIGHTS224 GALLEYOUTLETS490 GALVANICISOLATOR225 GARBAGEDISPOSAL226 GASALARM228 GEN1229 GEN2454 GENOFF-ON-START230 GENROOMBLOWER466 GENRUNNING455 GENSTOP227 GENERALPURPOSE523 GENERATOR231 GFIOUTLET232 GPS233 GPS/LORAN234 GPS/PLOTTER510 GUNLOCKS235 GYROCOMPASS236 HAILER

Label No. Label Text Label No. Label Text Label No. Label Text

Custom 360 Panel Worksheet—Standard Label List

Page 5 of 8990343360 Rev. 005

237 HALLWAYLIGHTS238 HALONFIRESYSTEM239 HAMRADIO240 HEAD241 HEAD2242 HEAD2FAN243 HEAD2OUTLETS244 HEAD3245 HEAD3FAN246 HEAD3OUTLETS247 HEAD4248 HEAD4FAN249 HEAD4OUTLETS250 HEADFAN251 HEADLIGHTS256 HEADLIGHTS252 HEADLIGHTS2253 HEADLIGHTS3254 HEADLIGHTS4255 HEADOUTLETS257 HEATER519 HEATER&AIRCONDIT258 HEATER2259 HEATER3260 HEATER4261 HELMELECTRONICS262 HELMGAUGES263 HELMINST264 HIGHWATERALARM265 HOLDINGTANK266 HOLDINGTANKALARM267 HOLDINGTANKPUMP268 HOODFAN269 HOODLIGHT270 HORN475 HOTTUB271 HOTWATERPUMP548 HOUSE549 HOUSE/ENG550 HOUSE/GEN272 HYDRAULICALARM273 HYDRAULICSYSTEM274 HYDRAULICTANKALARM275 ICEMAKER276 IGNITION277 IGNITIONPORT278 IGNITIONSTBD279 INSTLIGHTS280 INSTRUMENTS281 INTERCOM282 INTERCOMHAILER283 INTERCOM/TELEPHONE284 INTERIORLIGHTS556 INTERNET285 INVERTER467 INVERTER2476 INVERTERACBUS471 INVERTERACSUPPLY470 INVERTERDCSUPPLY286 INVERTEROUTLET287 ISOLATIONTRANSFORMER479 KITCHEN484 KITCHENSLIDEOUT288 KNOTMETER289 LAZARETTELIGHTS290 LECTRASAN291 LIGHTER292 LIGHTS293 LIGHTS2294 LIGHTS3295 LIGHTS4296 LIGHTSAFT

494 LIGHTSAFTCABIN297 LIGHTSFWD493 LIGHTSMASTERCABIN495 LIGHTSPANTRY492 LIGHTSPILOTHOUSE298 LIGHTSPORT491 LIGHTSSETTEE299 LIGHTSSTBD300 LIVEWELL301 LIVEWELLINPUT302 LIVEWELLOUTPUT303 LOCKERLIGHTS304 LOG305 LORAN306 LPGCONTROL307 LUBEOILPUMP308 MACERATORPUMP309 MAIN314 MAINSAILFURLING310 MAINBREAKER311 MAINCABIN312 MAINCABINLIGHTS313 MAINCABINOUTLETS315 MAPLIGHT316 MASTLIGHTS317 MASTHEADLIGHT551 MEMORY318 MICROWAVE319 MINIDISCPLAYER320 MIZZENFLOOD325 NAVELECTRONICS326 NAVINST456 NAVLIGHTANCHOR-OFF-NAV327 NAVLIGHTS321 NAVSTATIONELECT322 NAVSTATIONGAUGES323 NAVSTATIONINST324 NAVSTATIONLIGHTS565 NETWORK328 NIGHTLIGHTS329 OFF331 OILCHANGEPUMP563 OILGAUGE332 ON330 ON-OFF333 OUTLETS334 OUTLETS2335 OUTLETS3336 OUTLETS4505 OUTLETSAFT337 OUTLETSDECK506 OUTLETSENGINEROOM338 OUTLETSEXTERIOR503 OUTLETSFORWARD339 OUTLETSINTERIOR504 OUTLETSPILOTHOUSE458 PANELLIGHTS496 PILOTHOUSEFAN340 PORT540 PORTFISHBOX534 PORTLIVEWELL341 PORTTHRUSTER552 PORT/STBDENG342 POWER343 POWERWASHER457 PREHEAT344 PRIMARYWINCHES345 PRINTER346 PUMP497 PUMPBLACKWATER498 PUMPGRAYWATER554 PUMPOUT

347 RACKLIGHTS348 RACKOUTLETS349 RADAR350 RADARARCHLIGHTS351 RADIO352 RANGE353 RDF483 REARSLIDEOUT354 RECEIVER355 RECEPTACLE356 REFRIGERATOR357 REFRIGERATORPUMP358 REFRIGERATOR/FREEZER359 REGULATOR360 REVERSEPOLARITY361 RODLOCKER489 RUDDERANGLEINDICATOR362 RUNNINGLIGHTS363 SAILINGCONTROLS364 SAILINGINST365 SALOON366 SALOONHEATER367 SALOONLIGHTS368 SALOONOUTLETS369 SALTWATERPUMP370 SAT/COM371 SAT/NAV372 SATELLITEDISH373 SCRUBBER374 SEARCHLIGHT375 SEARCHLIGHTHAND376 SEARCHLIGHTREMOTE377 SEAWATERTEMP378 SEAWATERWASHDOWN379 SECURITYSYSTEM380 SHIP381 SHORE463 SHORE1464 SHORE2382 SHORECORDREEL383 SHOREPOWER384 SHOREPOWERCORD385 SHOWERSUMPPUMP386 SINKDRAIN486 SLIDEOUT387 SOLARPANEL388 SONAR542 SONAR/ACC389 SPARE390 SPEED/LOG392 SPREADERLIGHTMIZZEN391 SPREADERLIGHTS393 SSB394 STABILIZER558 STAIRLIGHT395 STARBOARD396 START398 STARTPORT399 STARTSTBD397 STARTSTOP541 STBDFISHBOX533 STBDLIVEWELL400 STBDTHRUSTER401 STEAMINGLIGHT402 STEPLIGHT403 STEREO404 STERNLIGHT509 STERNTHRUSTER405 STOP406 STOVE407 STOVE/MICROWAVE408 STROBELIGHT

409 SUBPANEL410 SUMPPUMP411 SUMPPUMP2412 SYNCHRO564 TANKGAUGE413 TAPEDECK414 TELEPHONESYSTEM415 TEST416 TOWINGLIGHTS417 TRACKLIGHTS419 TRANSFORMER518 TRANSFORMERSECONDARY465 TRANSFER418 TRANSFERPUMP420 TRASHCOMPACTOR478 TRAVELLOCKS421 TRICOLORLIGHT422 TRIMTABS527 TROLLINGMOTOR423 TV424 TVANTENNA425 TV/STEREO426 TV/VCR535 UNDERWATERLIGHT 427 UPSSYSTEM428 UTILITY429 VACUUM430 VACUUMPUMP431 VCR432 VHF511 VHF1512 VHF2433 VIDEOPLOTTER434 VIDEOSYSTEM543 WASHDOWN513 WASHDOWNPUMP435 WASHER436 WASHER/DRYER437 WATERALARM562 WATERGAUGE438 WATERHEATER439 WATERLEVEL440 WATERMAKER441 WATERPRESSURE442 WATERPUMP443 WEATHERFAX444 WEATHERINST559 White(BLANK)553 WINCH445 WINCHES477 WINDGEN446 WINDINST522 WINDSHIELDVENT449 WINDSHIELDWASHER447 WINDEXLIGHT448 WINDLASS472 WIPERCENTER450 WIPERPORT451 WIPERSTBD452 WIPERS557 WIRELESS

Label No. Label Text Label No. Label Text Label No. Label Text Label No. Label Text

Custom 360 Panel Worksheet—Standard Label List continued

Page 5 of 8 Page 6 of 8990343360 Rev. 005

Please PRINT clearly in Label Templates provided below.

You are solely responsible for spelling and text breaks. A signed copy of this form must be returned electronically or via fax before your order can be processed.

Date

Signature

Custom 360 Panel Worksheet—Custom Label Order Form

Additional Label Templates on page 8

Page 7 of 8990343360 Rev. 005

You are solely responsible for spelling and text breaks. A signed copy of this form must be returned electronically or via fax before your order can be processed.

Date

Signature

Page 7 of 8 Page 8 of 8990343360 Rev. 005

Custom 360 Panel Worksheet—Custom Label Order Form continued