D. I. Roof Seamers      

Raising The Roof On The Seamer Industry.

DI Seamers 915 Hwy 45 Corinth, MS 38834 Office(888) 343-0456	FYI Lock Combination is Engraved on the bottom of the lock
Complete the Form online then use the "Print this Form" button then: For best results or if the full page does not print, set print properties to "shrink to fit" FAX the completed form to (662) 287-6744

Date <%=format (now,"dddd MMMM dd, yyyy")%> Bill To Ship To Company Company Contact Contact Address Address City/State City/State Zip Zip Phone Phone FAX FAX Email Email Job Information   Gauge:   22 24 26 PO# Roof Finish:   Galvalume Painted Job# Sq. Footage: Panel Manufacturer Seam Height: Product Code Pitch: Roof Material End Laps:   No Yes If Yes Qty: Note: **Hand Crimpers are required to form all seams. Each seam (TripleLok and QuadLok) requires a different hand crimper.** Special Instructions: Shipping: Ground 2nd Day Next Day Date Needed on site: Est. number of weeks to complete job: Pricing Seamer Rental Rate: I need @ $45 per day Can Opener Rental Rate: I need @ $75 per day Crimper Rental Rate: I need @ $3 per day Important: Credit Cards must have $1000 of available credit approved before your seamer will ship Credit Card:   Visa M C Discover Card Number Exp Date Code {3 digit code on back of card) Signature: __________________________________________________________

Charges begin the day you receive the tool until it is returned. Rental days are Mon - Fri Your credit card will be charged at the end of the month or when the equipment is returned. Your credit card will be charged $225 ea for hand tools not returned with the electric seamer. Damages other than normal wear and tear will be documented and charged accordingly. Please return the tool to the address on top of the cooler. Builder is responsible for return freight. *Continental US Only.