Your name*

Today's date* P.O.#

Email* Phone*

*We will confirm this order via e-mail

Apt.#* Apt. size* select one 1 bdrm 2 bdrm 3 bdrm 4 bdrm 5 bdrm

Install Date* Floor plan*

Installation time* A.M. P.M.
A.M.'s are before 12 noon and P.M.'s are after 12 noon

Is the apartment* occupied vacant
*If the apartment is occupied please ask the resident to move personal items prior to the install date.

• Please check the services requested for this apartment

Do you want vinyl nafco (vinyl wood plank)*

What areas do you want installed?

Do you want us to pull the toilet?* yes no

Do you need quarter-round?* yes no

Do we need to take up the old vinyl?* yes no
If so, what areas?

Is the apartment*
townhouse flat

Are there any sub-floor concerns?* yes no
If so, what are they?

Do you need the sub-floor sealed to prevent oders?*
yes no

Vinyl or Nafco color and style
*We have this information on hand if you are unsure.

Special request for this install

We will leave your apartments clean after we finish your job. If you ever find any job not clean, please call us. We will make it right.