Chase Cover Order Form

Business Name:*

Name of person submitting order:

First NameLast Name

Email Address:*

example@example.com

Phone Number:*

Please enter a valid phone number.

Job Name or Number:*

Date Order Placed:*

Date

Estimated production turn-around is 7-10 business days

If Expedited production is required, please choose options below.

Same Day = $175 additional charge - Must receive order before 10amNext Day = $125 additional charge - Must receive order before 10amNormal Rush (3 to 5 business days) = $50

If Expedited production is required, please choose options below.

Same Day = $175 additional charge (Must receive order before 10am)Next Day = $125 additional charge (Must receive order before 10am)Normal Rush (3 to 5 business days) = $50

How would you like to receive your product?*

Pick-up - Monday thru Friday from 7am to 4pmDelivery - Delivery charge will be added on invoice

How would you like to receive your product?*

Pick-up (Monday thru Friday from 7am to 4pm)Delivery (Delivery charge will be added on invoice)

If you choose delivery option, please type your address below.

Delivery Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Notes:

Please provide accurate measurements to the closest 16th of an inch! We recommend adding 1/4" to all measurements to allow cap clearance when placing on chimney.

Measurement of side 1 in inches (Longest side):*

Measurement of side 2 in inches:*

Measurement of side C in inches:

Measurement of side D in inches:

Skirt Height (Std 3")*

Metal Choice*

Stainless SteelPac-CladPlain GalvanizedCopper

How many holes are needed?

123

Color Choice for Pac-Clad

Enter wholesale price from chart provided

If price is left blank, we will add on official order form. Sales Tax will be added on official order form.

If there are 3 holes, fill in all hole measurements for D, A & B.

If one hole is required, fill out info below for hole D.

What is the measurements of hole D? (1" increments)

What is the collar Height? (Standard is 2")

What is the shape of the hole?

Is the hole centered?

YesNo

If hole is not centered, please fill out hole placement measurements following drawing above. D1 & D2 are most important.

D3 & D4 can be calculated if we have hole size and D1 & D2 measurements.

What is the measurement for D1?

What is the measurement for D2?

What is the measurement for D3?

What is the measurement for D4?

If two holes are needed, fill out for holes A & B below.

For first hole, fill in all info for hole A.

What is the diameter of hole A? (1" increments)

What is the collar Height for hole A? (Standard is 2")

Please fill out hole placement measurements following drawing above. A1, A2, B1 & B2 are most important.

A3, A4, B3 & B4 can be calculated if we have hole size, A1, A2, B1 & B2 measurements.

What is the shape of the hole A?

What is the measurement for A1?

What is the measurement for A2?

What is the measurement for A3?

What is the measurement for A4?

For second hole, fill in all info for hole B.

What is the diameter of hole B? (1" increments)

What is the collar Height for hole B? (Standard is 2")

What is the shape of the hole B?

What is the measurement for B1?

What is the measurement for B2?

What is the measurement for B3?

What is the measurement for B4?

ORDERING PROCESS
After your order is submitted, the following will happen:

You will receive an official order via email requesting approval
When order is approved, you will receive an invoice
When the invoice is paid, we will fabricate your order
When your order is complete, we will notify you

Please feel free to contact us with any questions: 612-445-0025

Dave@SotaMetalFab.com

ChimGuard Chase Cover