Custom Liner Price Quote
PRINT THIS FORM........... fill it out, and FAX it to 509-766-0414
 
               Contact Name:      ______________________________________________
 
               Company Name:    _____________________________________________
 
               Billing Address:     _____________________________________________
 
                                            _____________________________________________
 
               Shipping Address:  ____________________________________________
 
                                             ____________________________________________
 
               E-mail:                   _____________________________________________
 
               Phone Number:      ________________ Fax Number: __________________
 
               Size of Tarp:         (Ex: 100' x 100')_________________________________
 
               Purpose of Tarp:  _____________________________________________
               (oil field, waste water containment, irrigation pond, landfill liner, etc.)
 
               Material Requirement: ___________________________________________
               (12 mil, 16 mil, 20 mil, 20 mil HD, 24 mil, 30 mil LLDPE, 40 mil LLDPE)
 
               Special Instructions/Comments/Questions: 
 
               ___________________________________________________________
 
               ___________________________________________________________
 
               ___________________________________________________________
 
               I would prefer my quote via: E-mail ____  Phone ____ Fax ____

Fax completed form to "SALES: 509-766-0414"
Inland Tarp & Cover, Inc.
4172 N Frontage Rd. E
Moses Lake, WA  98837
 
Thank you for your inquiry. A Sales Associate will contact you shortly.