ORDER DATE:

DESIGN:

ACCOUNT #:

A ~ DESIGN & SHOWROOM INFORMATION

SIDEMARK:PO#:

E ~ CLIENT INFORMATION

DESIGNER NAME:

EMAIL:

ADDRESS:

:LLEC:LET

EMAIL:

:LLEC:LET

SHIP TO ADDRESS:

END USER’S NAME:

ADDRESS:

EMAIL:

:LLEC:LET

TERMS: Price quotes honored for 60 days. Balance due before delivery. 50% deposit required on all orders.

QUOTE STRIKE-OFF ORDER

SHOWROOM:

SALES ASSOCIATE:

HTGNELHTDIW :EZIS GUR

B ~ DIMENSIONS

C ~ COLORS

X

SAME AS SAMPLE

CUSTOM COLOR:

A/B

C/D

A/B. C/D.

KARASU

COLOR: JAVA

• 2 0 1 C E N T R A L A V E N U E S O U T H , B E T H P A G E , N Y 1 1 7 1 4 • 8 0 0 . 4 5 3 . 3 5 6 3 , P R O M P T 4 • F A X : 5 1 6 . 2 9 3 . 1 7 3 4 • L E E J O F A . C O M

D ~ SPECIAL INSTRUCTIONS

Please specify color numbers below.

All other colors subject to upcharge.

See Lancaster Color Chart for wool options in 220 S & NW colors.

This pattern has four colors; two blended in ground, two blended in design.Choose one color for each position. Weavers will match format of sample.

COST P/SQ.FT:

RUG COST:

LABOR:

FREIGHT:

TOTAL:

DEPOSIT:

BALANCE:

:ETAD:# KCEHC

AMEX MASTERCARD VISA

CARD NUMBER:

EXP DATE:

NAME ON CARD:

SIGNATURE:

TOTAL SQ.FT:

PAD :

*Fibers will be dyed to match color numbers indicated. *Variations in color, texture and irregular weaves are natural characteristics of hand made rugs. *Natural, undyed wools can vary up to 8% in color.

To expedite your order, you can pre-authorize to charge the balance to the credit card information above. Please initial here ___________________

W

L

Size Limitations; Minimum : 4’ X 6’, Maximum: 28’ X 50’