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PANELS, SHOWER BASES & ACCESSORIES

Date: ______________________ P.O. # : ___________________________

CUSTOMER AND SHIPPING INFORMATION Customer Name: ____________________________________ Ship To Name: _____________________________________ Ship To Address: ___________________________________ City: ____________________ Province / State: __________________ Postal / ZIP Code: ____________ Telephone # : ___________________________ E-mail Address: _______________________________

PRODUCT TYPE / MEASUREMENTS   PRODUCT TYPE / MEASUREMENTS    Std. Tub Kit    Soap / Shampoo Comb. ( R / S )    Shower Base    Soap Dish ( R )    Back Panel    Tissue Holder ( R )    Left Panel    Towel Bar    Right Panel    Corners 1" x 1"    Ceiling Panel    Sill   NOTE: ( R ) = Recessed, ( S ) = Surface Mount  Tub Skirt

CUSTOM PANELS: _____________________ _____________________ _____________________ _____________________ _____________________ _____________________ _____________________ _____________________