Patio Cushions Plus Quote Form

Email: admin@patiocushionsplus.com
Fax: (760) 471-8420
(items in BOLD are required)

ORDERED BY: SHIP TO:( only if different than ordered by )
First Name:
First Name:
Last Name:
Last Name:
Address:
Address:
City
City
State
State
Zipcode
Zipcode
Phone:
Phone:
Email :
Email :
Cushion Specifications:
MEASUREMENTS
EXAMPLE
CUSHION
A
CUSHION
B
CUSHION
C
CUSHION
D
CUSHION
E
OVERALL LENGTH
39.5
WIDTH
20.5
BACK LENGTH
20
SEAT LENGTH
19.5
 
         
Cushion Letter
(from above)
Model No.
(Price List )
DESCRIPTION
Fabric #
Qty.
Price
TOTAL
EXAMPLE
CC01
LOW BACK CUSHION
 
 
Handling Charges:
$10.00
   
TOTAL PRICE & SHIPPING-
Payment Details :
Card Type:
Card Number:
Exp. Date: /
A Check for $ is enclosed.
Signature: _____________________________________________
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Email: info@patiocushionsplus.com