<p> FERMA FLOORING 83 Mayfield Avenue. Edison, NJ 08837 Tel: 732-225-5200 Fax: 732-225-5290 E-Mail: [email protected] www.fermaflooring.com Customer Name: (Please Print) </p><p>Email: Address:</p><p>City, St, Zip:</p><p>Tel: Fax: Shipping Address : ( Please print)</p><p>City, St. Zip: </p><p>Tel: Fax: </p><p>Requested Shipping Date: Ship Via : Quantity Item Number Item Description Price Amount</p><p>Display Rack Rack Size:36(W)x78”(H)x21"(D), hold 32/64 Hand- #HS-1-6 boards Hand-board Size: 23.5"(H) x 18.5 (W),</p><p>Display Rack Rack Size: 19.68"(D)x20.4"(W)x74.8"(H), hold 14 #PY-1-14 boards Board Size: 18” x 16”</p><p>Display Rack Each rack has 2 columns, hold 32 boards totally #JZ2-16 Board Size: 18” x 16” Rack Size: 16(D) x 35.63"(W) x 78.7 "(H)</p><p>Display Rack Each rack has 3 columns, hold 42 boards totally #WZ-3-14 Board Size: 16”x12” Rack Size: 85.63"(H) x 54.37"(W) x 19.68"(D)</p><p>Display Rack Each row holds 3 sample boards, hold 12 boards #WD-1-12 totally Board Size: Adjustable Rack Size: 83.66"(H) x 39.37"(W) x 15.75"(D)</p><p>Special Note: </p><p>FERMA Display Rack/Floor sample Order Form FERMA FLOORING 83 Mayfield Avenue. Edison, NJ 08837 Tel: 732-225-5200 Fax: 732-225-5290 E-Mail: [email protected] www.fermaflooring.com Floor Sample Order : </p><p>Quantity Item# Description Price Amount</p><p>3/4" Solid Exclusives Collection # 1 (Total : 8) 209N 3-1/4 White Oak , Natural Color 2089-C 3-1/4”, Northern Oak, Cherry Color 2089G 3-1/4”,White Oak , Gunstock Color 2089-MO 3-1/4” Northern Oak , Mocha 208N 3-1/4” White Oak, Natural Color 2089B 3-1/4” Northern Oak, Butter Scotch Color 2089H 3-1/4”Northern Oak, Honey Color 206N 4”, American Hickory, Natural Color Total ¾” Solid Tropic Collection #2 (Total : 2) </p><p>207-I 4-3/4 “, African Walnut, IPE Stain </p><p>207-T 4-3/4 “, African Walnut, Teak Stain </p><p>Total : </p><p>3/4" Solid Classical Collection #3 (Total : 6) </p><p>207-HWA 4-3/4 “, African Walnut, Walnut Stain 207-HWI 4-3/4 “, African Walnut, IPE Stain </p><p>206HTP 6”, American Hickory, Topaz Color 206HH 6”, American Hickory, Honey Color 229HDB 4-3/4”, Pacific Maple, Dark Brown, 229HGB 4-3/4”, Pacific Maple , Golden Brown,</p><p>FERMA Display Rack/Floor sample Order Form FERMA FLOORING 83 Mayfield Avenue. Edison, NJ 08837 Tel: 732-225-5200 Fax: 732-225-5290 E-Mail: [email protected] www.fermaflooring.com Total Quantity Item Item Description Price Amount Number 3/4" Solid Rainforest Collection #3 (Total: 12)</p><p>203-N 3-5/8”, Santos Mahogany ( Red Cabreauva) Natural Color</p><p>215-C 2-5/6” or 3-5/8” , Brazilian Rosewood , Coral Color </p><p>212-N 3”, Tiger Wood, Natural Color </p><p>212-N 4-3/4”, Tiger Wood, Natural Color </p><p>203-NB 3” , Santos Mahogany (Balsamo), Natural Color</p><p>202-N 2-1/2”, Brazilian Cherry, Natural Color</p><p>202N 4-3/4” or 3-1/4”, Brazilian Cherry, Natural Color 218-N 3-5/8” Brazilian Walnut, Brown Color 205-N 3”, Brazilian Teak, Natural Color </p><p>205-S 4-3/4”, Brazilian Teak , Mahogany Red Color</p><p>203 –TC** 3-5/8” , Santos Mahogany (Balsamo), Terra Cotta Color Total Quantity Item Item Description Price Amount Number 1/2" Engineered # 4 </p><p>7206-HH 5”, American Hickory, Honey Color, Antique</p><p>7207HWA** 4-3/4”, African Walnut, Walnut Color, Antique** 6203-N 3-5/8, Santos Mahogany(Red Cabreuva) Natural Color , Amazon 6203-N 5”, Santos Mahogany (Red Cabreuva), Natural Color Amazon 6209-B 3-1/4”, White Oak, Butter Scotch Color, Traditional 6219-G 3-1/2”, Brazilian Oak, Golden Color, Amazon</p><p>6219TC 4-1/4”, ”, Brazilian Oak, Terra Cotta Color, Amazon</p><p>FERMA Display Rack/Floor sample Order Form FERMA FLOORING 83 Mayfield Avenue. Edison, NJ 08837 Tel: 732-225-5200 Fax: 732-225-5290 E-Mail: [email protected] www.fermaflooring.com 6212-N 3-5/8”, Brazilian Tiger Wood, Natural Color, Amazon 6209-N 3-1/4”, White Oak, Natural Color, Traditional ** 6209-MO 3-1/4”, White Oak, Mocha Color , Traditional** </p><p>7230-C 5”, Pacific Maple, Cinnamon Color, Traditional** </p><p>7230-CL 5”, Pacific Maple, Camel Color, Traditional ** </p><p>7230-U 5”, Pacific Maple, Cinnamon Color, Traditional** Total </p><p>Quantity Item Number Item Description Price Amount</p><p>Bamboo 5/8" Green Collection # 5 (Total: 5) </p><p>G36SWT 3-3/4”, Bamboo, Strand Woven, Tiger Wood Color, Green Collection G36SW-N 3-3/4”, Bamboo, Strand Woven, Natural Color, Green Collection G36SW-C 3-3/4”, Bamboo, Strand Woven, Carbonized, Green Collection G36SW-N-CLK 5”, Bamboo, Strand Woven, Natural Color </p><p>G36SW- C-CLK 5”, Bamboo, Strand Woven, Carbonized Color, 36GSW-W-CLK 5”, Bamboo, Strand Woven, Carbonized Color, 36GSW-KNA-CLK 5”, Bamboo, Strand Woven, Natural Kemper Color, 36GSW-KM-CLK 5”, Bamboo, Strand Woven, Mahogany Kemper Color, Total Engineered, Easy Click Collection, 10mm #6 (Total: 3) </p><p>7209-N 5”, White Oak, Natural Color, Easy-Click, Engineered, 7202-N 5”, Brazilian Cherry, Natural Color, 10mm, Engineered </p><p>FERMA Display Rack/Floor sample Order Form FERMA FLOORING 83 Mayfield Avenue. Edison, NJ 08837 Tel: 732-225-5200 Fax: 732-225-5290 E-Mail: [email protected] www.fermaflooring.com 7217-N 5”, Sapele, Natural Color, Engineered </p><p>Total Click Luxury Vinyl Plank - Natural Click Collection #7 (Total: 6) </p><p>3208HDO Sahara Desert Oak – Hand-scraped Embossed 3209-HSO Saddle Oak – Hand-scraped Embossed 3218-CW Caramel Walnut – Registered Embossed 3216-CC Classic Chestnut – Registered Embossed</p><p>3228-AW Antique Walnut – Registered Embossed</p><p>3206-N Natural Hickory – Registered Embossed</p><p>3206-AH Autumn Hickory – Registered Embossed 3206-SS Sandstone Hickory – Registered Embossed Total Quantity Item Number Item Description Price Amount</p><p>Laminate – Premium & Value Collection # 8 (Total: 8) </p><p>8202-N Brazilian Cherry, Natural Color, Premium Collection 8203-N Santos Mahogany, Natural Color, Premium Collection 8206-P Pacific Hickory Color, Premium Collection</p><p>8213-N American Cherry, Natural Color, Premium Collection 8217-N Acacia Teak , Natural Color, Premium Collection 8218-N Brazilian Walnut, Natural Color, Premium Collection 9208N Red Oak, Natural Color, Value Collection 9208-G Gunstock Oak 8mm Color, Value Collection Total </p><p>FERMA Display Rack/Floor sample Order Form FERMA FLOORING 83 Mayfield Avenue. Edison, NJ 08837 Tel: 732-225-5200 Fax: 732-225-5290 E-Mail: [email protected] www.fermaflooring.com Hand-boards # 9 (Total : 10) Vinyl Hand-board of 6 Styles (3209HSO + 3208HDO + 3206N + 3218CW + 3228AW +3216CC) Vinyl Hand-board of 2 styles (3206SS + 3206AT) Strand Bamboo Hand-board of G36SWT + G36SWN +G36SWT Strand Bamboo Hand-board of G36 SWNCLK + G36SWCCLK African Solid Hand-board of 207HWA/207HWI/207T /207I 1 Laminate Hand Board of 6 Styles 8202N + 8203N + 8206P + 8213N+ 8207N +8218N Premium Laminate 1 Easy Click 10mm Hand Board -3 Colors, Engineered 7217N, 7209N. 7202N Rainforest Collection Brazilian series, Hand-board ,Solid 1 Northern Oak Board -8 styles Traditional Classical + Tropic Engineered Hand-board (African) Traditional Collection Engineered Hand-board Total</p><p>Special Note: Any special instruction for board size, shipping time, date, etc. </p><p>Total Display Rack to ship</p><p>FERMA Display Rack/Floor sample Order Form FERMA FLOORING 83 Mayfield Avenue. Edison, NJ 08837 Tel: 732-225-5200 Fax: 732-225-5290 E-Mail: [email protected] www.fermaflooring.com Total Boards to ship</p><p>Subtotal: Note: Due to the nature of wood flooring and variations inherent in wood, small samples of these products may not be Discount : representative of the floor's overall appearance. It is possible that some FERMA floor sample may experience changes in color when Total exposed to light for extended periods of time. Color changes may be more dramatic in certain species. Tax: Shipping Clerk Initials: </p><p>Total Amount Due Customer Signature: </p><p>FERMA Display Rack/Floor sample Order Form</p>