Order Request

Order Form

Sales Rep Information

Please include your sales rep information

Do you have a Kolay sales representative?

Yes, I have a sales rep

No, I do not have a sales rep

First Name

Last Name

Customer Information

Some description about this section

Company Name

First Name

Last Name

Phone Number

Shipping Information

Some description about this section

Delivery Method

Please allow a 2-hour window for will call pickup.

Liftgate

Does the delivery require a liftgate?

Address type

Ship to address

Address Line 1

Address Line 2

City

State

Zip Code

Bill to address

Address Line 1

Address Line 2

City

State

Zip Code

Product Information

Some description about this section

Flooring

Color	System	Size	Thickness	Wear Layer	Quantity

Baseboard

Profile	Color	Quantity

Metal Trim

Profile	Color	Quantity

Moldings

Profile	Color	Quantity

Moldings

Product	Color	Quantity

Underlayment

Product	Quantity

Project Information

Some description about this section

Project Name

Project Type

PO Number

Project Specifier

Date Needed

Additional Information

Some description about this section

File Upload

Choose File

Comments / Instructions

Sales Rep Information

Customer Information

Shipping Information

Product Information

Project Information

Additional Information

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