Order

Lowtis Woodworks, LLC
406 North 10th Street
Lake City, MN 55041
Ph. (651) 345-6424
Fax (651) 345-6426

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NetMerchants, LLC

Please complete all of the following information. Click on the submit button when finished and your information will be sent to us. We will contact you to confirm your order and go over the details.

Thank you very much for your business!

Customer Name
Address
	City State Zip
Phone Number
Fax Number
Email Address
PO Number
Ebay Order #

Surround Name
Unit Style	Cabinet Corner Flush
Base	Yes No
Top	None Cabinet Corner Corner w/Pocket Pier Flush Mirror

Mantel Only	(enter desired mantel width below)
Mantel Width Desired (for mantel only orders)		This is measured across the top of the mantel.

Wood Species

Wood Finish

Non-Combustibles

Fireplace Model (ex. Kozy SP942)

Measurements:	Please use inches only. (ex. 36 1/2)
Fireplace Opening Width		This is "X" on the measurement guide.
Fireplace Opening Height		This is "Y" on the measurement guide.
Mantel Facing Material Depth		This is "Z" on the measurement guide.
Mantel Facing Material Height		This is "W" on the measuremnt guide .
Mantel Facing Material Width		This is "I" on the measurement guide .
In the box below, please include other measurements listed on the measurement guide you feel would be neccessary to accurately fullfill your order. These measurements would only be neccessary under special circumstances as noted in the diagram.