Thank you for Filling Fire Pit Quotation Form

Project Name

Sales Rep

Product:

Select your product

Quantity

Colour

Ash

Charcoal

Nougat

Corten Steel

Colour

Corten Steel

Burner Type

Match-lit

Electronic*

*Requires Outdoor Receptacle (120VAC)

Burner Type

Wood-burning

Match-lit

Electronic*

*Requires Outdoor Receptacle (230V)

Fuel Type

Natural Gas

Propane

What is size of propane tank will you be using to fuel your fire pit? *

20 lbs

40 lbs

Larger than 40 lbsLarger than 40 lbs

Not sure

Some gas installations require an accessible manual shut-off: *

Yes, this is taken care of

Please discuss the options with me

Decorative Topping

Lava Pebble

River Rock – Dark Grey

River Rock – Light Grey

OtherOther

Decorative Topping

Lava Pebble

River Rock – Dark Grey

River Rock – Light Grey

OtherOther

Standard Accessories

All-Weather Cover

Metal Inset Cover

Standard Accessories

Metal Inset Cover

Standard Accessories

All-Weather Cover

Optional Accessories

Tempered Glass Screen

Controls – for Electronic Burners

Quantity

Timers

Quantity

Emergency Stops

Quantity

Add Another Product Remove Product

BIll To:

Company

Company Name must match the Tax Exception form uploaded below, if applicable

Billing Contact

Phone Number

Email Address

Address

City

State/Province

Zip/Postal

Country

Ship To:

Note: taxes are applied based on the destination address

Same as “BIll To”?

Yes

Shipping Contact

Phone Number

Email Address

Address

City

State/Province

Zip/Postal

Country

Payment Options

I’ll be paying by:

Credit Card (Visa or MC)

ACH

Cheque

I will be paying

50% deposit (balance due prior to shipping)

Full payment

I am tax exempt

Yes

No

If yes, please upload your tax exemption certificate here (pdf, jpg or png)

Maximum file size: 134.22MB

Quotation Form

Product:

BIll To:

Ship To:

Payment Options

You are currently on the Paloform - Global website

Welcome to Paloform