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HOSELINE, INC.
701 NW 37th AVENUE
OCALA, FL. 34475
407-802-2599
WWW.HOSELINE.COM
E-MAIL: sales@hoseline.com
DEAR CUSTOMER: HOSELINE, INC. MUST HAVE FURNISHED TO
THEM THE FOLLOWING INFORMATION BEFORE HOSELINE, INC.
CAN PROCESS YOURORDER!
TRUCK WORKSHEET-VEHICLE INFORMATION
TYPE of Bracket Kit Type A: Without factory A/C adding (1) compressor to OEM location.
Type B: With factory A/C adding a second compressor.
Type C: Without factory A/C adding two (2) compressors.
Year Of Vehicle Make Of Vehicle Model Of Vehicle
# of Cylinders Engine #
Liter Size / CID of Engine
WITH OR WITHOUT FACTORY A/C
Standard or Power Brakes Air Brakes ? Yes or No
Standard or Power Steering
Conventional or Tilt Cab
TYPE OF OEM COMPRESSOR ( S )
ALTERNATOR ( TYPE )
SINGLE OR DUAL
ALT. Make and Model
Smog or Air Pump ?
What Type of Engine Clutch Do You have on the Vehicle ?
Electric Other Please Explain
Horton
Viscous Air
SPECIAL COMMENTS, INFORMATION OR REQUESTS:
