Replacement Fabric Order Form Replacement Fabric Order Form Part 1: Order Information Step 1: Dealer * Address * Address Address Address City City State/Province Alabama Alaska Arkansas Arizona California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State/Province Zip/Postal Zip/Postal Contact # * Email * Step 2: Homeowner * * Homeowner information required for warranty purposes and installation / delivery. Homeowner Address * Homeowner Address Homeowner Address Homeowner Address City City State/Province Alabama Alaska Arkansas Arizona California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State/Province Zip/Postal Zip/Postal Step 3: Installation Labor * Dealer Pool Cover Pros Step 4: Delivery Options * Homeowner Address Dealer Address Pick Up from PCP Pick Up from APC Other (Enter Below) Other Delivery Address Other Delivery Address Other Delivery Address Other Delivery Address City City State/Province Alabama Alaska Arkansas Arizona California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State/Province Zip/Postal Zip/Postal Part 2: Job Specifications Step 1: Unit Type * APC Coverstar Cover Pools Aquamatic PCS Cantar OtherOther Step 2: Track Type * Top Track Wheels Top Track Carriages Flush Track Wheels Flush Track Carriages Under Track Step 3: Track Space * Width - FeetWidth - Feet Width - InchesWidth - Inches Length - FeetLength - Feet Step 4: Location * Indoor Outdoor Step 5: Mount * Recessed Deck Mount Deck Mount with Vinyl Bench Step 6: System Type * Keyswitch Touchpad Hydraulic Manual Step 7: Lead Edge Loop * Standard 3" Large 4" No Step 8: Replacement Parts Kit * Yes No Step 9: Fabric Color * Light Blue Royal Blue Navy Blue Light Gray Charcoal Gray Beige Brown Green Step 10: Notes Please verify: Submit
