The "Ultimate Evil" One Bar Prison Custom Order Form V1.2 Choose from either Section A (complete package) or Section B (a la carte parts). Then specify options in Section C. Section A (complete package): Select one or both of: ☐ Base with sliding platforms (specify minimum pole height in Section C)* ☐ Non-sliding base (specify minimum pole height in Section C)* Section B (a la carte parts): Select any of: ☐ "Nuts/washers/bolts" hardware package ☐ Unistrut package (2 channel sections, 8 rollers, 4 end caps, 12 clevis pins and hitch pin clips)* ☐ Modified 3XLR connector(s)** quantity ____________ ☐ Reinforcement plate ☐ Connecting plate for reinforcement plate ☐ Cubes (set of 6) ☐ Pole (specify minimum height and connector type in Section C)** ☐ Noise reduction tubing (set of 8) ☐ Dildo - specify connector and type(s) ______________________________ ☐ Non-slip foot mats (specify color) ___________________ ☐ Spring(s) and dowel(s) (identify spring model and dowel length in additional comments section) (not available if "future evil" pre-wire option is selected) ☐ Yellow DANGER label(s) (specify custom text in the comments section if desired) quantity _____________ ☐ Printed manual ☐ Other part(s) - specify ______________________________ Section C (options): Select one of: ☐ Decorative trim ☐ Without decorative trim Select one of: ☐ 3XLR connector ☐ KlicLok connector Select one of: ☐ Unfinished wood ☐ Stained wood (specify finish) ________________________ ☐ Stained and finished wood (specify finishes) ________________________ and ________________________ Specify: ☐ Minimum pole height (inches) from platforms to mating face of 3XLR connector (see manual)*** ____________ ☐ Pre-wire pole for "future evil" options (not available if spring and dowel are ordered) ☐ Extra copies of printed manual ____________ For complete devices only, select one of: ☐ Yellow DANGER label(s) (specify custom text in the comments section if desired) ☐ No DANGER label(s) Additional comments for order: _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ Notes: * Oversized / heavy item - must be picked up or shipped via motor freight ** If both the modified 3XLR connector and pole are ordered the connector will be mounted to the pole adapter *** Maximum pole height as determined by minimum height (see manual) Contact me for pricing information and the length of time needed for construction.