Customer Custom Chase Cover Request Form Customer Name(Required) MaterialStainlessCopperOtherIf Other, which material? Powder Coated Yes No If Yes, which color? Vertical Skirt with Drip Edge (Measured in inches) 2 in. 3 in. 4 in. 5 in. 6 in. Other Collar Height (Measured in inches) 2 in. 3 in. 4 in. Other If Other, which height (Measured in inches) Collar Diameter 6 in. 8 in. 10 in. 12 in. Other If Other, how many inches? Storm Collar Needed? Yes No If Yes, then which size? Number of Collars 1 in the center 1 not centered 2 Other If Other, how many? Please list the total width of the cover in inches (shorter side). Please list the total width of the cover in inches (longer side). Additional InformationEmail PhoneConsent(Required) I agree to the privacy policy.NumberEmailThis field is for validation purposes and should be left unchanged. Δ
