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						|  | L-403-M Series |  | 
                    
						|  | * | 1. Are you a Arizona resident? |  |  |  | 
                    
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						|  | * | 2. Do you want Metal
  Clips which secure the glass to your cabinet frame included in this estimate?
  The average insert size requires 6 clips per cabinet frame at $.70 ea. |  |  |  | 
                    
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						|  |  | Quantity |  | Width |  | Height |  | Each |  | Total |  | 
                    
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						|  |  |  |  | Retaining Clips |  |  |  |  |  |  | 
                    
						|  |  |  |  | Subtotal |  |  |  | 
                    
						|  |  |  |  | Sales Tax |  |  |  | 
                    
						|  |  |  |  | Shipping |  |  |  | 
                    
						|  |  |  |  | Total |  |  |  | 
                    
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						|  | Estimate Void 30 days after this date |  |  |  | 
                    
						|  | Order This
  Item |  |  | 
                    
						|  |  | Fill in the
  information below if you would like to receive via email the Order Form
  Package required to place an order for this item at the price shown above
  within the next 24 hours. |  | 
                    
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						|  | * | First and Last Name |  |  | 
                    
						|  | * | Shipping Zip Code |  |  | 
                    
						|  | * | Email Address |  |  | 
                    
						|  | * | Re-type Email Address |  |  | 
                    
						|  |  | Telephone (Optional) |  |  | 
                    
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						|  | * | Does the front of
  your cabinet frame have an arch or curved area? |  |  |  | 
                    
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						|  | * | Is the opening for
  glass on the backside of the frame a rectangle or has an arched top? |  |  |  | 
                    
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						|  | * | Are the sizes you
  entered above estimated sizes or accurate sizes? |  |  |  | 
                    
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						|  | Comments |  |  | 
                    
						|  |  | Enter any additional
  information below you feel would help us prepare your Order Form Package |  | 
                    
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						|  |  | All lines that begin
  with a red asterisk * must be completed |  | 
                    
						|  |  | If we receive your Request For Order Forms over the
  weekend you will receive it on the following Monday. |  | 
                    
						|  |  | Select the Submit
  Button below |  | 
                    
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