Place Order

Order ID

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Date Submitted

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Request Type

Order Information

Order For*

Kolay Flooring

Kolay Manufacturing

Sales Rep Information

Do you have a Kolay Sales Representative?*

Yes

No

Sales Rep Name*

First Last

Sales Rep Email*

Customer Information

Customer Company Name

Customer Name*

First Last

Customer Phone*

Please indicate the customer phone number whom this order is billed to.

Customer Email*

Please indicate the customer emails whom this order is billed to.

Project Name / Side Mark*

Please indicate the name or side mark of this project.

PO Number

Please indicate the PO number if applicable.

Job Type*

Please indicate which job type this order form is for.

Specifier

Please indicate the architect/designer if applicable.

Shipping & Bill To Information

Will Call*

Do you wish to will call this order?

Yes

No

Do you wish to make your own shipping arrangements?*

Yes

No

After making arrangements, please provide us with your shipping details.

Bill To*

Please indicate which address you would like the order to be billed to.

Street Address Business Name City State / Province / Region ZIP / Postal Code Country

Ship To*

Please indicate which address you would like the order to be shipped to.

Same address as bill to

Street Address Business Name City State / Province / Region ZIP / Postal Code Country

Does this delivery require a lift gate?*

Yes, delivery requires a lift gate

No, delivery does not need a lift gate

Flooring

Color		System	Thickness	Wear Layer	Size	Quantity	U/M	Price	Actions

There are no Products.

Wall Protection

Color		System	Thickness	Wear Layer	Size	Quantity	U/M	Price	Actions

There are no Products.

Ceiling Tile

Color		System	Thickness	Wear Layer	Size	Quantity	U/M	Price	Actions

There are no Products.

Shower Panel

Color		System	Thickness	Size	Quantity	U/M	Price	Actions

There are no Products.

Baseboard

Style	Color	Quantity	U/M	Price	Actions

There are no Products.

Woven Vinyl

Colors		System	Size	Quantity	U/M	Price	Actions

There are no Products.

Carpet Tile

Color	Size	Quantity	Price	Actions

There are no Products.

Trim & Accessories

Profile	Metal Color	SPC Color	Quantity	U/M	Price	Actions

There are no Products.

Artificial Turf

Product	Quantity	U/M	Price	Actions

There are no Products.

Adhesive

Product	Quantity	Price	Actions

There are no Products.

Underlayment

Product	Thickness	Quantity	U/M	Price	Actions

There are no Products.

Freight Quote*

Do you already have a freight quote?

Yes

No

Freight Quote #

Please provide freight quote # if applicable.

Material Need Date*

Please indicate when this material is needed by.

Email Invoice To*

Please indicate which email(s) you want the invoice emailed over to.

PO Upload

Please upload your personal order form or PO here.

Drop files here or

Max. file size: 256 MB.

Comments / Notes

Order Information

Sales Rep Information

Customer Information

Shipping & Bill To Information

Product Information

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