Order Form - Fax or Phone - Deco Crete Designs, LA, FL, TX, MS, AL, GA

Fax Order Form

Print out this Order Form and fax it to 504.367.6781

Terms & Conditions of Sale

Payments shall be received in full before the orders are shipped. Payments can be made using major credit cards like Visa and Master Card. We also accept Company and Cashier's Checks. Please note that shipping and applicable taxes are extra.

To order, enter the quantity beside the product you wish to order. Please note the color and weight options for each product.

Cementitious Overlays/Toppings

QTY.	PRODUCT	COLOR	WEIGHT (lbs)
	Pentimento	Grey	50
	Pentimento	White	50
	Sgraffino	Grey	30
	Sgraffino	White	30
	Sgraffino Fine	Grey	22
	Sgraffino Fine	White	22
	Sgraffino Superfine	Grey	20
	Sgraffino Superfine	White	20
	Rotofino	Grey	40
	Rotofino	White	40

Primer/Activator

QTY.	PRODUCT	COLOR	WEIGHT (lbs)
	Cp1000	-	10
	Cp1000	-	50

Acid Stains

QTY.	PRODUCT	COLOR	WEIGHT (lbs)
	Patinaetch	Blue Copper	10
	Patinaetch	Blue Copper	50
	Patinaetch	Amber	10
	Patinaetch	Amber	50
	Patinaetch	Ebony	10
	Patinaetch	Ebony	50
	Patinaetch	Sumatra	10
	Patinaetch	Sumatra	50
	Patinaetch	Aged Buff	10
	Patinaetch	Aged Buff	50
	Patinaetch	Lapis	10
	Patinaetch	Lapis	50
	Patinaetch	Azul	10
	Patinaetch	Azul	50

Integral Powder Colors

QTY.	PRODUCT	COLOR	WEIGHT (lbs)
	Colorfast	Cork	10
	Colorfast	Charcoal Suede	10
	Colorfast	Flint	10
	Colorfast	Fresco	10
	Colorfast	Mica	10
	Colorfast	Caramel	10
	Colorfast	Celadon	10
	Colorfast	Nimbus Grey	10
	Colorfast	Interno	10
	Colorfast	Chamois	10
	Colorfast	Pewter	10
	Colorfast	Dune	10
	Colorfast	Chintz	10
	Colorfast	Cotta	10
	Colorfast	Potters Clay	10
	Colorfast	Sedona	10
	Colorfast	Verde	10
	Colorfast	Aqua	10
	Colorfast	Burnt Umber	10
	Colorfast	Oilve Branch	10
	Colorfast	Putty	10
	Colorfast	Spring Dew	10
	Colorfast	Ivory	10
	Colorfast	Sage	10
	Colorfast	Carbon Black	10

Sealer and Floor Finish

QTY.	PRODUCT	COLOR	WEIGHT (lbs)
	Deco Seal	-	10
	Deco Seal	-	50
	Texture Seal	-	10
	Texture Seal	-	50
	Uro Finish	-	10
	Uro Finish	-	50

Water Based Dyes

QTY.	PRODUCT	COLOR	WEIGHT (lbs)
	Someru Dye	Black	10
	Someru Dye	Red	10
	Someru Dye	Sea Blue	10
	Someru Dye	Yellow	10
	Someru Dye	Burly Wood	10
	Someru Dye	Coral	10
	Someru Dye	Dark Rod	10
	Someru Dye	Dark Orange	10
	Someru Dye	Gold	10
	Someru Dye	Grey Slate	10
	Someru Dye	Khaki	10
	Someru Dye	Magenta	10
	Someru Dye	Olive Green	10
	Someru Dye	Peru	10
	Someru Dye	Purple	10
	Someru Dye	Salmon	10
	Someru Dye	Rosy Brown	10
	Someru Dye	Reef Green	10
	Someru Dye	Sienna	10
	Someru Dye	Teal	10

Solvent Based Dyes

QTY.	PRODUCT	COLOR	WEIGHT (lbs)
	Decographic Dye	Black	10
	Decographic Dye	Red	10
	Decographic Dye	Sea Blue	10
	Decographic Dye	Yellow	10
	Decographic Dye	Burly Wood	10
	Decographic Dye	Coral	10
	Decographic Dye	Dark Rod	10
	Decographic Dye	Dark Orange	10
	Decographic Dye	Gold	10
	Decographic Dye	Grey Slate	10
	Decographic Dye	Khaki	10
	Decographic Dye	Magenta	10
	Decographic Dye	Olive Green	10
	Decographic Dye	Peru	10
	Decographic Dye	Purple	10
	Decographic Dye	Salmon	10
	Decographic Dye	Rosy Brown	10
	Decographic Dye	Reef Green	10
	Decographic Dye	Sienna	10
	Decographic Dye	Teal	10

Installation Tools

QTY.	PRODUCT	COLOR	WEIGHT (lbs)
	Turbo Roller	-	1
	Texture Roller	-	0.5
	Knee Boards	-	10
	Spiked Shoes	-	1
	Magic Trowel	-	0.5

Account Info:

Company Name:	(required)
Contact Name:	(required)
Tel:	(required)
Email:	(required)

Payment Method:

NOTE: If you wish to pay by credit card, please enter your information below. Otherwise, we will contact you to arrange payment. VISA MasterCard Cheque Cash
Credit Card Number:
Name of Card Holder: (exactly as on card)
Billing Address:
Expiry Date: (month/year)

Shipping Method:

Customer will pickup at Deco-Crete warehouse
Ship via Deco-Crete Courier
Ship via Customer Courier (call when ready)

Special Instructions: