Customer Information
Name:_______________________________________________________ Date:________________

Address:_________________________________________________ Due Date:________________

City:_____________________________________ State:__________ Zip:_____________________

Phone #:___________________________ E-Mail:_________________________________________

Block Information
Block Serial #:______________________ Make:______________________ Model:___________________

  • AEBS T-Sleeve Installation, w/ Bore, Hone & Deck:                     Yes                No
  • Darton M.I.D. Sleeve Installation, w/ Bore, Hone & Deck:           Yes                No
  • Darton Flanged Sleeve Installation, w/ Bore, Hone & Deck:         Yes                No
  • Straight Sleeve Installation, w/ Bore, Hone & Deck:                      Yes                No
  • Block O-Ringing (Additional Fee):                                                    Yes                No
  • Align Bore/Hone Main Bearing Saddles (Additional Fee):              Yes                No

    • Payment Details

     Deposit Amount Included (Minimum deposit = 50%): $_____________________________

  • Make Cashiers Check or Money Order payable to: Custom Design Performance
  • Please ship to the address below. If you have any questions, please feel free to call.

    Custom Design Performance.com, llc.

    28 Barbara Road
    Vernon, CT 06066
    Verizon (860) 614-6381


    Send E-Mail to Ken Carlson with questions or comments about this web site.
    Copyright © 1987-2007, Custom Design Performance.com, llc.

    NOT RESPONSIBLE FOR TYPOGRAPHICAL ERRORS. SPECIALS NOT AVAILABLE AT ALL LOCATIONS, BRAND NAMES MAY VARY. PRICES SUBJECT TO CHANGE WITHOUT NOTICE.