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Customer Inquiry Form
We welcome your inquiry. Please take a moment to complete the form below and click Submit Inquiry.

 

Surface or Type of Tile

 
 

Ceramic   Terrazzo
Quarry   Marble
Slate   Bathtub 
If Other, Please Specify:

 
 

Type of Application

 

Restaurant     Commercial Office Building
Health Care (Hospital, Managed Care, etc.)     Bath/showers/pool/spa
School     Janitorial/Safety
Municipality     Government
Food Processing     Residential/Home

 
 

Type and Amount of Traffic

 
 

Amount of Traffic:
  Heavy     Medium     Light

Type of Traffic:
  Foot     Motorized     Wheelchairs
Other:

 
 

Describe Your Problem

 
 

Please describe your existing condition/problem.
(Employees or customers slipping, falling)

 
 

Your Contact Information

 
 

Your Name*

Home Phone

E-mail Address
*

 

Business Phone (and extension)*

Address

City

 

State

 

Zip