Smoking Shelter

Name*

Email*

Phone*

How did you hear about us?*—Please choose an option—InternetDirect MailReferralPrevious Customer

Company Name*

Address

City*

State*—Please choose an option—AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming

Zip*

If the jobsite/ship-to-address is different than above, please provide:

Job Name

Solicitation #

Job Zipcode

City*

State*—Please choose an option—AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming

Material*—Please choose an option—AluminumSteel

Shelter Use/Type*—Please choose an option—SmokingTransitWaitingEquipmentVending MachineUtilityVestibuleOther

Quantity*

Size*—Please choose an option—4 x 44 x 84 x 104 x 125 x 85 x 105 x 125 x 156 x 86 x 106 x 126 x 158 x 88 x 108 x 128 x 158 x 1610 x 1010 x 1210 x 1510 x 1810 x 20Custom

Custom Size

Colors—Please choose an option—Dark BronzeClear AnodizedCustom Powder Coated

Other Color
If other, please provide color, manufacturer, and color code

Shelter Wall Style*—Please choose an option—Full GlassHalf Glass/Half PanelFull Panel

Ventilation Space*—Please choose an option—No VentilationOpen Top VentilationOpen Bottom VentilationOpen Top & Bottom Ventilation

Glass*1/4" Tempered Safety Glass (Standard)1/4" Polycarbonate/LexanInsulated Glass

Tinted Glass—Please choose an option—YesNo

Roof Type*—Please choose an option—Flat Roof (Standard)Standing Seam Metal Hip RoofPolycarbonate Hip RoofMetal Gable RoofAcrylic Dome RoofPolycarbonate Barrel Vault Roof

Do you require shelter assembly or installation?YesNo

Purchase Date*—Please choose an option—Planning/BudgetEstimating for current bid/proposalPurchasing within 48 HoursPurchasing within 1 WeekPurchasing within 2 WeeksPurchasing within 30 DaysPurchasing within 90 DaysPurchasing within 6 MonthsPurchasing within 1 Year

Attach Plans, Specs, or Photos

Comments/Questions