Blossman Gas, Inc. Signage Quote Request

Blossman Gas, Inc.

Signage Quote Request
Vendor Details
Request For Quote Prepared For:*

Vendor NameContact Name
Vendor Contact Number:

Area CodePhone Number
Vendor Email:
example@example.com
Vendor Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Notes/Comments:
Blossman Gas, Inc. requests all vendors complete a Vendor Setup Request Form and W9 for account changes/ updates as they needed and/on an annual basis, to ensure your account information is complete and accurate. Please find attached a fillable PDF of both forms. Completed forms should be emailed to swanadmin@blossmangas.com.
Blossman Location & Contact Details
Branch Location #: *
Branch Name:*
Branch Address:*
Branch Contact #:
Branch/ Location Name, Address, Contact No., Area, Branch/ Location No.*
*If the Location Address is not listed above, manual enter the Location Address here:

Street Address

Street Address Line 2

CityState

Zip Code
Branch Manager:*

First NameLast Name
Branch Manager Contact Number:*

Area CodePhone Number
Branch Manager Email:*
Regional VP:*
Regional VP Contact Number:*
Regional VP Email:*
Regional Vice-President Email Address
Area/Department:*
Billing Address & Contact Details:

Blossman Gas- Swannanoa Administrative Office 2091 US Highway 70 Swannanoa, NC 28778

828-251-0027
Billing Contact Name:

First NameLast Name
Billing Address Email:
Request Details
Request Date:

MonthDayYear
Date
Request Installation To Be Completed On or Before:

MonthDayYear
Date
Company File updateNew InstallationComplete ReplacementSign Face ReplacementAwning Installation- NewAwning Installation- ReplacementOther
Request Details:
>>>>Please Note:
All signage, design, material, color, etc. must be approved by our Director of Design- Ann Weidie (828-423-7999)
All agreements, contracts and renderings must be approved by our President/ CEO- Stuart Weidie (828-251-0027)

Sign Ordnances, Restrictions & Permitting
Known Restrictions/ Barriers Regarding Sign Placement, Design, Size, Etc.
To be completed by Administrative Office
Quote Details
Quote Amount $:
Additional Quote Amount $:
Quote Details:
Completion Date is Expected on or Before:

MonthDayYear
Date
Signage Quote Approved by:
Date Approved:

MonthDayYear
Date

Post Installation:
Actual Completion Date:

MonthDayYear
Date
You can add multiple saved photos to this form by clicking on the Select Photos button, below.
Post Installation- Front View- 1
Post Installation- Front View- 2
Post Installation- Side View- 1
Post Installation- Side View- 2
You can add multiple saved photos to this form by clicking on the Select Photos button, below.
Upload Post Installation Signage Photos

Select Photos

Cancelof
Actual Cost $
Should be Empty:

>>>>Please Note:

You can add live photos to this form from any smart device. Click on the Take Photo Button below to add a photo.

You can add multiple saved photos to this form by clicking on the Select Photos button, below.

To be completed by Administrative Office

Post Installation:

You can add multiple saved photos to this form by clicking on the Select Photos button, below.

You can add multiple saved photos to this form by clicking on the Select Photos button, below.