*Property/Company:
Lock Box#:
*Address:
Gate Code#:
*City:
Unit#:
*State:
*Zip:
Unit Style:
Unit Size:
*Preferred Install Date (MM/DD/YY):
Requested Work to be Done:
Carpet:
Vinyl:
VCT:
Special Instructions(if other selected, please complete this field):
*Ordered By:
*Phone:
Email:
Reference Purchase Order #:
(if applicable)
This form authorizes Classique Floors to do work on the property listed above. Please note that there may be an extra charge if any additional work is necessary. Payment terms are thirty (30) days. All past due payments will be charged 1.75% per month.
Please enter an email to receive a confirmation of this request.

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7307 Roseville Road Suite 11 • Sacramento CA 95842 • (916) 348-8887
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