FACTORY ORDER FORM DIMENSIONS: A: Inches B: Inches C: Inches Spa Cover Type: Premium 2 Pound Standard 1 Pound Child Safety Sumo Safety Quad Other Other: Corners: Pointy - 90 Degree Radius Inches Cut Corner Inches Spa/ Hot Tub Manufacturer: Model: Type: Portable In-ground Acrylic In-ground Gunite Straps: 2 Straps 4 Straps No Straps Skirt or Bottom Flap: (Write in if split or other) Skirt/Flap Size: Standard 2-1/2 In Split Other Other: Color: Almond Black Brown Burgundy Charcoal Forest Green Granite Indigo Light Grey Navy Blue Peacock Redwood Brown Tan Teal Tropical Blue White Foam: Standard - 1 lb Foam Premium 2 lb. Foam Pillows: Qty: 0 1 2 3 4 5 6 7 8 9 $12.95 ea. Cover Lifts: Qty: 0 1 2 3 4 5 6 $189.00 Total: $ Payment: VISA MASTER CARD AMERICAN EXPRESS Check or Money Order (Sorry! No COD's) Name: Address: City: State: Zip code: Country: (Yes, we can ship outside the US) Email: Phone: (With Area Code) Fax: How may we contact you? E-mail | Fax | Phone