Contact Information Name*
First
Last
Email*
Phone*
Relationship to Project* [Please Select] Architect/Engineer/Consultant Distributor End User Integrator Manufacturing Rep Other
Are You Working With A Partner On This Project? [Please Select] Yes No/Unsure Tell Me More
Partner Company/Name
Partner Email
Project Information Location*
Anticipated Order Date Product What Type Of Product Do You Need? [Please Select] Pedestal Call Box Phone Software Parts Other
Choose Your Pedestal Model [Please Select] CB 1-e CB 1-s CB 1-w CB 5-s CB 5-p CB 9-s CB 9-t
Choose Your Call Box Model [Please Select] CB 2-a CB 2-e CB 2-s CB 4-s CB 4-r CB 4-u CB 6-f CB 6-s
Choose Your Phone Model [Please Select] Centry® IP Video Help Point® IP5000 VoIP Speakerphone IP2500 VoIP Speakerphone IP1500 VoIP Speakerphone (Only available in single button) IA4100 Analog Speakerphone
Choose Your Pedestal Color [Please Select] Safety Blue Safety Red Gloss Black Gloss White Bright Silver Safety Yellow Cardinal Red Midnight Blue Tiger Orange British Racing Green Dark Bronze Medium Bronze Custom (Additional fees will apply)
Choose Your Call Box Color [Please Select] Stainless Steel (CB 2-a, CB 2-e, CB 2-s, CB 6-s) Safety Blue Safety Red Gloss Black Gloss White Bright Silver Safety Yellow Cardinal Red Midnight Blue Tiger Orange British Racing Green Dark Bronze Medium Bronze Custom (Additional fees will apply)
Choose Your Phone [Please Select] IP5000 VoIP Speakerphone IA4100 Analog Speakerphone No phone; enclosure only
How Many Buttons Do You Need? [Please Select] One Two Two With Keypad (IP5000, IA4100 only)
Choose Your Main Bezel Text [Please Select] Push For Help Emergency Emergency/Emergencia Custom (Additional fees will apply)
Choose Your Graphics Text [Please Select] Emergency Assistance Courtesy Police Security Information Help Point Custom (Additional fees will apply)
Choose Your Graphics Color [Please Select] Blue Black White Green Red Yellow Custom (Additional fees will apply)
Note: Do not make your graphics and enclosure the same color. (Example: Safety Blue pedestal with blue graphics.)
Choose Your Main Button Text [Please Select] Emergency Assistance Custom (Additional fees will apply)
Do You Need An Enclosure? [Please Select] Yes-Pedestal Yes-Call Box Yes-Surface Mount Yes-Flush Mount No-Phone Only
What Type Of Mount Do You Need? [Please Select] Flush Mount Surface Mount
Choose Your Power Note: Options shown may not be available for the selected build. Please reference products pages to learn more.
[Please Select] 12-24V AC/DC 120, 240, 277 or 347V AC NightCharge®/Switched Grid PoE Unknown/Various
Options Note: Options shown may not be available for the selected model. Please reference products pages to learn more.
Options Note: Options shown may not be available for the selected model. Please reference products pages to learn more.
Do You Need Software? [Please Select] ToolVox® X3 Blue Alert® EMS Blue Alert® MNS Unknown/Other-Tell Me More Not At This Time
What Type Of Software? ToolVox® X3 Blue Alert® EMS Blue Alert® MNS
Click to select; hold CTRL to select multiple products.
What Type Of Parts Do You Need? Lights Speakers Curb Mount Mounting Ring GSM Cellular Anchor Bolt Kit Security Bits Other
Click to select; hold CTRL to select multiple products. Don't see what you need? Visit codeblue.com/request to request a Parts Catalog.
Part Number/Name
Quantity
Need Another Product? Product No. 2 What Type Of Product Do You Need? [Please Select] Pedestal Call Box Phone Software Parts Other
Choose Your Pedestal Model [Please Select] CB 1-e CB 1-s CB 1-w CB 5-s CB 5-p CB 9-s CB 9-t
Choose Your Call Box Model [Please Select] CB 2-a CB 2-e CB 2-s CB 4-s CB 4-r CB 4-u CB 6-f CB 6-s
Choose Your Phone Model [Please Select] Centry® IP Video Help Point® IP5000 VoIP Speakerphone IP2500 VoIP Speakerphone IP1500 VoIP Speakerphone (Only available in single button) IA4100 Analog Speakerphone
Choose Your Pedestal Color [Please Select] Safety Blue Safety Red Gloss Black Gloss White Bright Silver Safety Yellow Cardinal Red Midnight Blue Tiger Orange British Racing Green Dark Bronze Medium Bronze Custom (Additional fees will apply)
Choose Your Call Box Color [Please Select] Stainless Steel (CB 2-a, CB 2-e, CB 2-s, CB 6-s) Safety Blue Safety Red Gloss Black Gloss White Bright Silver Safety Yellow Cardinal Red Midnight Blue Tiger Orange British Racing Green Dark Bronze Medium Bronze Custom (Additional fees will apply)
Choose Your Phone [Please Select] IP5000 VoIP Speakerphone IA4100 Analog Speakerphone No phone; enclosure only
Choose Your Phone [Please Select] IP5000 VoIP Speakerphone IA4100 Analog Speakerphone No phone; enclosure only
How Many Buttons Do You Need? [Please Select] One Two Two With Keypad (IP5000, IA4100 only)
How Many Buttons Do You Need? [Please Select] One Two Two With Keypad (IP5000, IA4100 only)
How Many Buttons Do You Need? [Please Select] One Two Two With Keypad (IP5000, IA4100 only)
How Many Buttons Do You Need? [Please Select] One Two Two With Keypad (IP5000, IA4100 only)
How Many Buttons Do You Need? [Please Select] One Two Two With Keypad (IP5000, IA4100 only)
How Many Buttons Do You Need? [Please Select] One Two Two With Keypad (IP5000, IA4100 only)
How Many Buttons Do You Need? [Please Select] One Two Two With Keypad (IP5000, IA4100 only)
How Many Buttons Do You Need? [Please Select] One Two Two With Keypad (IP5000, IA4100 only)
Choose Your Main Bezel Text [Please Select] Push For Help Emergency Emergency/Emergencia Custom (Additional fees will apply)
Choose Your Main Bezel Text [Please Select] Push For Help Emergency Emergency/Emergencia Custom (Additional fees will apply)
Choose Your Main Bezel Text [Please Select] Push For Help Emergency Emergency/Emergencia Custom (Additional fees will apply)
Choose Your Main Bezel Text [Please Select] Push For Help Emergency Emergency/Emergencia Custom (Additional fees will apply)
Choose Your Main Bezel Text [Please Select] Push For Help Emergency Emergency/Emergencia Custom (Additional fees will apply)
Choose Your Main Bezel Text [Please Select] Push For Help Emergency Emergency/Emergencia Custom (Additional fees will apply)
Choose Your Main Bezel Text [Please Select] Push For Help Emergency Emergency/Emergencia Custom (Additional fees will apply)
Choose Your Graphics Text [Please Select] Emergency Assistance Courtesy Police Security Information Help Point Custom (Additional fees will apply)
Choose Your Graphics Color [Please Select] Blue Black White Green Red Yellow Custom (Additional fees will apply)
Note: Do not make your graphics and enclosure the same color. (Example: Safety Blue pedestal with blue graphics.)
Choose Your Main Button Text [Please Select] Emergency Assistance Custom (Additional fees will apply)
Do You Need An Enclosure? [Please Select] Yes-Pedestal Yes-Call Box Yes-Surface Mount Yes-Flush Mount No-Phone Only
What Type Of Mount Do You Need? [Please Select] Flush Mount Surface Mount
Choose Your Power Note: Options shown may not be available for the selected build. Please reference products pages to learn more.
[Please Select] 12-24V AC/DC 120, 240, 277 or 347V AC NightCharge®/Switched Grid PoE Unknown/Various
Options Note: Options shown may not be available for the selected model. Please reference products pages to learn more.
Options Note: Options shown may not be available for the selected model. Please reference products pages to learn more.
Do You Need Software? [Please Select] ToolVox® X3 Blue Alert® EMS Blue Alert® MNS Unknown/Other-Tell Me More Not At This Time
What Type Of Software? ToolVox® X3 Blue Alert® EMS Blue Alert® MNS
Click to select; hold CTRL to select multiple products.
What Type Of Parts Do You Need? Lights Speakers Curb Mount Mounting Ring GSM Cellular Anchor Bolt Kit Security Bits Other
Click to select; hold CTRL to select multiple products. Don't see what you need? Visit codeblue.com/request to request a Parts Catalog.
Part Number/Name
Quantity
Additional Information Tell Us More About How We Can Help
Tell Us More About How We Can Help
Other Products, Requirements Or Specifications For This Project
Documents Please attach any specification documents you have for this project.
