AeroConversions products distributed Worldwide by: Sonex Aircraft, LLC AeroInjector Order Form 511 Aviation Road Oshkosh, WI 54902 Tel. (920) 231-8297 Fax (920) 426-8333 Email: [email protected] 10/2/14 Date of Order: Please Print Clearly Name: Daytime Phone: Email: Shipping Address: City, State/Province, Country, Postal Code: Payment Method (USD only): ! Check/Money Order/Cashier’s Check ! Visa ! MC ! AMEX Funds Transfer (bank fees apply) ! No.: Exp.: The AeroInjector will be installed on: Aircraft Make & Model: / ! Cash CID#: Engine Make & Model: AeroInjector (select model from list below)………...…………………………………………………………………….$395.00 Mount Style Type** Typical Application* Model No. 32mm 1.5” OD Spigot AeroInjector VW (1600 – 2180cc) ACV-C07S 32mm 2” OD Spigot AeroInjector Jabiru 2200 ACV-C07LS 32mm 2.5” Flange AeroInjector Continental 65, 85, & 90 ACV-C07F 35mm 2” OD Spigot AeroInjector Jabiru 3300, Corvair ACV-C08LS 2.5” Flange AeroInjector Continental 0-200, Corvair ACV-C08F Size 35mm Qty *Please speak with an AeroConversions representative to determine the recommended AeroInjector for your application. **AeroInjector is a 9oz. lighter version of the AeroCarb. AeroInjector Accessories: Part No. ACV-C10-10 Description Intake Flange Mount Adapter Price $35.25 ACV-Spigot-Hose Spigot Hose Mnt w/ Clamps $20.34 ACV-Q01-01 Throttle Quadrant (side) $98.00 ACV-Q01-03 Throttle Quadrant (center) ACV-C10-30 Air Filter Assembly** Qty Total $108.00 $60.00 **The air filter and intake flange mount adapter cannot be used together unless remote-mounting the air filter assembly. Accessories Total Payment Terms: Order must be paid in full prior to shipment. Shipping Charges: AeroInjectors are shipped via UPS from the Sonex factory in Oshkosh Wisconsin. Shipping charges are calculated and prepaid prior to shipment. Sales Tax: 5% Wisconsin Sales Tax must be applies to all orders delivered within Wisconsin or picked up at Sonex Aircraft, LLC. Prices and policies are subject to change without notice. Full terms and conditions apply to all orders (see www.sonexaircraft.com). AeroInjectors are for Experimental Use Only, and must not be installed on certified aircraft. Subtotal $ . 5% WI Sales Tax (if applicable) $ . Total Due $ .