Please enable JavaScript in your browser to complete this form.Property or complex name: *Ordered by: *Purchase order#:Contact phone #: *Contact email *Install address: *Is this an apt? *YesNoApt #: *Unit type: *Requested install date: *Move in date:Unit status: *VacantOccupiedInstaller to move furniture? *YesNoFLOORINGSelect all that apply:CarpetSheet VinylLuxury Vinyl (plank or tile)OtherCarpetCarpet style & color: *Our preferredOtherSpecify other carpet style/color: *Padding *New padNew, if neededUse existingGluedownArea(s) to carpet: *EntireOtherSpecify areas for carpet: *Base for carpeted areas: *Vinyl cove base4 1/4" baseboardQuarter-roundNoneHaul away old carpet & pad? *YesNoAdditional information or instructions for carpeted areas:Sheet VinylVinyl style & color: *Our preferredOtherSpecify other vinyl style/color: *Area(s) for vinyl: *EntireOtherSpecify areas for vinyl: *Move appliances? *N/AYesNoCommodes *N/APull onlyReset onlyPull & resetCut aroundBase for vinyl areas: *Vinyl cove base4 1/4" baseboardQuarter-roundNoneAdditional information or instructions for vinyl areas:Luxury Vinyl (plank or tile)Luxury Vinyl style/color: *Our preferredOtherSpecify other luxury vinyl: *Area(s) for luxury vinyl: *EntireOtherSpecify areas for luxury vinyl: *Move appliances? *N/AYesNoCommodes: *N/APull onlyReset onlyPull & resetCut aroundBase for luxury vinyl areas: *Vinyl cove base4 1/4" baseboardQuarter-roundNoneAdditional information or instructions for luxury vinyl areas:Other FlooringType of flooring: *HardwoodLaminateCeramic TilePlease note, an Account Manager will contact you to assist you with your order for these specialized flooring products.Additional information or instructions for other flooring: *Submit
