STAPLE TOP OF SAMPLE HERE

STAPLE TOP OF SAMPLE HERE (TOP OF CHAIR) PHOTOCOPY AND USE THIS FORM AS OFTEN AS NECESSARY * SAMPLE & AUTHORIZATION REQUEST FORM G LOBA NEW FABRIC REQUEST IF THIS IS A NEW FABRIC REQUEST, FILL OUT THIS FORM WITH YOUR ATTACHED FABRIC SAMPLE Or BY THE WIDTH OF THE ROLLI AND MAIL TO: GLOBAL UPHOLSTERY ATTN: GRACE MARTIRE 560 SUPERTEST ROAD • DOWNSVIEW, ONTARIO • M3J2M6, CANADA DATE MAILED: CPREVIOUSLYAPPROVED FABRIC IF THIS ISA PREVIOUSLY APPROVED FABRIC, A NEW AUTHORIZATION NUMBER MUST BE ISSUED. FAX OR MAIL THIS COMPLETED FORM TO: GLOBAL INDUSTRIES ATTN: COM CONTACT P.O. BOX 562 • MARLTON, NJ 08053 • FAX 856-596-5684 PREVIOUS RGA CUSTOMER INFORMATION (To Be Completed By The Dealer) DEALER/COMPANY NAME: CONTACT: BILLING ADDRESS: PHONE: CITY: STATE: FAX: LOCAL GLOBAL DISTRIBUTION CENTER: DATE: FABRIC INFORMATION (To Be Completed By The Dealer and/or Mill) FABRIC NAME (SERIES) & STYLE S. FABRIC COLOR NAME AND DESCRIPTION - COUNTRY OF ORIGIN - MILL OR MANUFACTURER'S NAME. FABRIC CONTENT (96COTTON, %POLY., %WOOL, ETC.): DOES THIS FABRIC CONTAIN FILAMENT, COTTON or WOOL? DESIGNER OR SPECIFIER OF FABRIC: WIDTH: CHAIRS ORDERED WITH C.O.M. FABRIC WILL BE PRICED AT CHAIR'S LOWEST AVAILABLE FABRIC GRADE PRICE. IF QUANTITY IS LESS THAN 6 ITEMS, A 10% UPCHARGE WILL APPLY. PRODUCT INFORMATION PURCHASE ORDER: QUANTITY MODEL/FRAME COLOR OPTIONS FABRIC DIRECTION ~ STAPLE FABRIC TO THIS FORM IN THE DIRECTION IN WHICH THE FABRIC IS TO BE UPHOLSTERED WITH THE TOP OF THIS PAGE BEING THE SAME AS THE TOP OF THE CHAIR. USE A SEPARATE FORM FOR FACH FABRIC REQUESTED. ONCE THE FABRIC HAS BEEN APPROVED AND/OR AN AUTHORIZATION NUMBER HAS BEEN ISSUED, A SET OF FORWARDING INSTRUCTIONS (FOR THE FABRIO WILL BE MAILED OR FAXED TO YOU. PI EASE NOW • Do not send ANY fabric without these documents and the COSI. Authorization Number! • GLOBAL can not be responsible for fabric received without the Approval Aclinonledgement Number. • GLOBAL is not responsible for the duty and fees for the fabric to clear customs. There charges will be billed to the dealer. • Customer's Om Material. BOTTOM OF SAMPLE HERE (BOTTOM OF CHAIR) a O 343 EFTA00521730