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Material Order Form
Name
*
Company
Phone
*
Email
*
Billing Address
Shipping Address (if different)
Street
*
Street
City
*
City
State
*
State
Zip
*
Zip
Services Training Street
Material Selection
Total Square Footage Required
*
Material Selection / Mix Design
*
Please choose an option
**HD2000** - Standard Duty 50/50 Rubber/Stone Paving (FLAGSHIP PRODUCT - Light Vehicular & Pedestrian)
ASX3000 - All Stone Paving (Vehicular Surface)
ASX2000 - All Stone Paving (Pedestrian Surface)
PH2000 - All Rubber Rubber Paving (Pedestrian Only)
PH1000 - All Rubber Rubber Paving (Overlay: Pooldecks, Patios, Courtyards)
PS2000 - All Rubber Paving (Playsurface)
Other
Color Selection
Dropdown
First Choice
Second Choice
Third Choice
Choice 13
Choice 12
Choice 11
Choice 10
Choice 9
Choice 8
Choice 7
Choice 6
Choice 5
Choice 4
blue
red
green
Delivery & Handling
Receiving Days
*
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Receiving Hours: Opening
*
Receiving Hours: Closing
*
Do you have a forklift at the receiving location?
*
Yes
No
Or, do you require a lift gate?
*
Yes
No
Special Delivery Instructions
Installation Services
Installer Training Needed?
*
Yes
No
*Installation training is required for first-time customers
If you are a Certified Flexi-Pave Installer, what is your certification number?
Additional Comments
Additional Notes or Special Requests
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