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KENDALL ELECTRIC, INC.
DELIVERY AUTHORIZATION


Customer Number:  
Customer Name (Customer):  

In the event the Customer is unavailable to sign for product it has ordered from Kendall Electric, Inc or Great Lakes Automation Supply (individually and collectively, "Kendall") at the time of delivery is attempted, Customer hereby authorizes Kendall or its agent to leave such product in the following designated area without obtaining customer's signature:
 
Designated Area to Leave Product
Customer agrees that this Delivery Authorization will serve as proof of delivery and Customer's acceptance of all product left by Kendall or its agent in the designated area specified above in the event no signature of receipt is available.
(MUST BE SIGNED, DATED AND WITNESSED)
     
Customer Signature (Must be Management Personnel)   Date
     
Witness   Date
     
Kendall Electric Inc   Date
     
Witness   Date


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