| Need by Date: |
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| 1st Size: Approximate size in Ft. |
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| 1st Choice: |
(Rug ID) |
| 1st Bid: (Not including sales tax or shipping charges) |
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| 2nd Size: Approximate size in Ft. |
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| 2nd Choice: |
(Rug ID) |
| 2nd Bid: (Not including sales tax or shipping charges) |
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| 3rd Size: Approximate size in Ft. |
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| 3rd Choice: |
(Rug ID) |
| 3rd Bid: (Not including sales tax or shipping charges) |
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| First Name: * |
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| Last Name: * |
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| Address Street: * |
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| City: * |
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| Zip Code: * |
(5 digits) |
| State: |
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| Daytime Phone: * |
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| Cell Phone: |
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| Email: * |
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| Comment: |
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