CHASE COVER ORDER FORM DATE- company NAME- PHONE# PO# / JOB NAME- Material: Select Material STAINLESS STEEL GALVANIZED COPPER BLACK BROWN WHITE DARK BRONZE PRIMER SIERRA TAN BRONZE GRAY GALVALUME WEATHERED COPPER OLD ZINC GRAY WEATHERED ZINC PREPAINTED (COLOR IN NOTES) Chase Cover Size 1) Long Side: 2) Short Side: 3) Long Side: 4) Short Side: Skirt Height: Skirt height 1 1.25 1.5 2 2.75 2.5 3 3.5 4 4.25 4.5 4.625 5 5.5 6 6.5 6.75 7 7.25 7.5 7.75 8 8.25 8.5 8.75 9 9.5 9.75 10 10.5 10.75 11 11.25 11.5 11.75 12 12 X 16 12.25 12.5 13 13.125 13.25 13.5 13.75 14 14.25 14.5 15 15.25 15.5 15.75 16 DRIP EDGE: Yes No Notes: Additional Features Rush + $75: COLLAR CENTERED: Yes No COLLAR SHAPE: Select Collar Shape ROUND RECTANGLE SQUARE LOOSE COLLAR NO COLLAR COLLAR DIAMETER: Select Collar Size 1 1.25 1.5 2 2.75 2.5 3 3.5 4 4.25 4.5 4.625 5 5.5 6 6.5 6.75 7 7.25 7.5 7.75 8 8.25 8.5 8.75 9 9.5 9.75 10 10.5 10.75 11 11.25 11.5 11.75 12 12 X 16 12.25 12.5 13 13.125 13.25 13.5 13.75 14 14.25 14.5 15 15.25 15.5 15.75 16 Collar Height: Select height 1 1.25 1.5 2 2.75 2.5 3 3.5 4 4.25 4.5 4.625 5 5.5 6 6.5 6.75 7 7.25 7.5 7.75 8 8.25 8.5 8.75 9 9.5 9.75 10 10.5 10.75 11 11.25 11.5 11.75 12 12 X 16 12.25 12.5 13 13.125 13.25 13.5 13.75 14 14.25 14.5 15 15.25 15.5 15.75 16 16.25 LOOSE STANDING COLLAR/SPIN RING: Yes No SIDE A1 TO COLLAR: SIDE A2 TO COLLAR: SIDE A3 TO COLLAR: SIDE A4 TO COLLAR: Short- Long- Storm Collar Yes No S.C. Flange Select S.C. Flange 1.25 1.5 2 2.75 2.5 3 3.5 4 4.25 4.5 4.625 5 5.5 6 6.5 6.75 7 7.25 7.5 7.75 8 8.25 8.5 8.75 9 9.5 9.75 10 10.5 10.75 11 11.25 11.5 11.75 12 12 X 16 12.25 12.5 13 13.125 13.25 13.5 13.75 14 14.25 14.5 15 15.25 15.5 15.75 16 Pipe Size Select Pipe Size 1.25 1.5 2 2.75 2.5 3 3.5 4 4.25 4.5 4.625 5 5.5 6 6.5 6.75 7 7.25 7.5 7.75 8 8.25 8.5 8.75 9 9.5 9.75 10 10.5 10.75 11 11.25 11.5 11.75 12 12 X 16 12.25 12.5 13 13.125 13.25 13.5 13.75 14 14.25 14.5 15 15.25 15.5 15.75 16 Corner Bolts Yes No
