Box 4086, #18, 321 Saskatchewan Avenue, Spruce Grove, Alberta, Canada. T7X 3B3 PH: 1-780-962-5060 FAX: 1-780-962-0501

Please provide information below for a Lea-Der Mat quotation:

Contact Name:		Phone:
Email:		Fax:
Company:		Rig #:

Rig Floor Matting:

Continental Emsco Gardner Denver Hacker Pyramid Ideco Round Ideco Square Midcontinent National Oilwell Skytop Brewster ZP 175 Side Mats Custom

Rig Mat Colour:	Safety Yellow Blue Red Orange Custom	If Custom:
Danger Area Colour:	Safety Yellow Blue Red Orange Custom	If Custom:
Side Mat Colour:	Safety Yellow Blue Red Orange Custom	If Custom:
Mat Wording:	Danger Danger Zone Peligro
Side Mat Thickness:	3/4" / 19mm 1 1/4" / 32mm

Please fill in measurements as required:

Measurements Provided In: Inches Millimetres

A		B		C		D
E		F		G		H
I		J		K		L
M		N		O		P
Q		R		S		T
U		V		W		X
Y		Z		AA		BB
CC		DD		EE

Drainage direction change required & marked on layout drawing Yes No

Sloped edges marked on layout drawing Yes No

Provide Extra Information: Request further information Provide manufacture specifications &/or instructions Comments