COVINGTON FLOORS
INTERNAL CLIENT INTAKE FORM
COVINGTON REP NAME
ADAM EXELBIERD
JOEL MOSS
DOVID THOMAS
PROJECT ENTRY DATE
MM slash DD slash YYYY
Time
Hours
:
Minutes
AM
PM
AM/PM
PROJECT NAME
QUOTE DUE DATE
MM slash DD slash YYYY
Time
Hours
:
Minutes
AM
PM
AM/PM
PROJECT CONTACTS
CONTACT NAME
ROLE
COMPANY
EMAIL
PHONE
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PROJECT ADDRESS
PROJECT ADDRESS
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
EXISTING SURFACE
EXISTING SURFACE MATERIAL
WOOD
URETHAINE
RUBBER
Other
WOOD
MAPLE
Other
WOOD GRADE
FIRST GRADE
SECOND GRADE
SECOND & BETTER
THIRD GRADE
UTILITY GRADE
Other
URETHAINE
PULASTIC
STRATA
Other
URETHAINE
MM
COLOR
Other
RUBBER
ROBBINS
NORTHWEST
Other
RUBBER
MM
COLOR
Other
SLAB DEPRESSION
INCHES
DEMOLITION
NOT REQUIRED
PARTIAL DEMOLITION
FULL DEMOLITION
Other
BLEACHER HANDLING
NOT REQUIRED
REQUIRED
Other
SECTIONS
NUMBER OF ROWS TALL
NUMBER OF BANKS
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DEMOLITION SQUARE FT CALCULATOR
PATCH LENGTH
PATCH WIDTH
TOTAL DEMOLITION SQUARE FEET
GYM - TOTAL SQUARE FT CALCULATOR
MULTIPLE ROOM DIMENSIONS
ROOM NAME
LENGTH
WIDTH
TOTAL SQ FT
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GYM WIDTH
GYM LENGTH
GYM SQUARE FEET
COURT LENGTH
84 FT
94 FT
Other
GYM LOCATION IN BUILDING
GROUND LEVEL
2ND STORY
Other
PROJECT START DATE
MM slash DD slash YYYY
TYPE OF WALL BASE
VENT COVE
RUBBER COVE
Other
LINEAR FEET
NUMBER OF CORNERS
TYPE OF DOOR TRANSITION
METAL
Other
LINEAR FEET
NUMBER OF DOORS
NUMBER OF 3 FT DOORS
NUMBER OF 6 FT DOORS
OTHER SIZED DOORS
YES
NO
ADDITIONAL DOORS
DOOR WIDTH
QUANTITY
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NOTES
ADA RAMPS
TYPE OF ADA RAMP
RUBBER
NONE
Other
LINEAR FEET OF RAMPS
RAMP LIST
TYPE OF RAMP
WIDTH
QUANTITY
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NOTES
VOLLEYBALL COVERS
TYPE OF VOLLEYBALL COVERS
NEW
EXISTING
Other
DIAMETER OF COVERS
QUANTITY
VOLLEYBALL COVER PICTURES
Accepted file types: jpg, jpeg, png, gif.
NOTES
BASKETBALL GOALS
GOAL ADJUSTMENTS
NOT REQUIRED
REQUIRED
Other
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NOTES
COURT DESIGN
GAME LINES
GAME TYPE
NUMBER
COLOR
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ADD ALL GAME LINES ITEMS ON COURT
LOGO
LOGO NAME
LOGO SIZE
NUMBER OF COLORS
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ADD ALL LOGO ITEMS ON COURT
ADD ALL LOGO IMAGES
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PROJECT NOTES
UPLOAD FIELD NOTES
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PROJECT IMAGES
UPLOAD ALL PROJECT IMAGES
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Max. file size: 8 MB.
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Comments
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