P.O. Box 23927, Columbia, S.C. 29224

Customer Information
Name: Contact:
Address: Phone:
City: Fax:
State: Zip:

QH&F Contact:

 

Color Sample Information:
Program Color & Number:
Will Color Chip Be Supplied For Matching? Yes    No  
IF Yes, Does Chip Need To be Returned? Yes    No  
Are Sample Q-Panels Required? Yes    No  

If Yes, How Many Are Required?

  
Is a Wet Sample of Color Required? Yes    No  
Gloss Level Requirements:  

 

Application Parameters:
Substrate Used:
Primer Used:  
Application Method:  
If Sprayed, What Equipment is Used?