Name:

Email:

Phone:

(You must provide a valid email address or phone number, otherwise we will not be able to contact you!)

Preferred colour (may not be exactly as shown):

black           blue             grey             tan         beige   

Shipping/Pickup:

pick up (former municipality of Scarborough, near intersection of Morningside and Lawrence)

shipped (shipping extra, based on postal/zip code)

     Address:

1.  Determine the:

            Height (H): inches

        Diameter (D): inches

2.  How far down from the top do the pipes enter the unit (PV)? 

                   PV: inches

                                          YOU’RE DONE!

Additional comments/notes:

By placing an order with Cuvers, you are agreeing to our Terms and Conditions.

Please note that this is an inquiry form only.  Following submission of this form, we will contact you to provide a quote and shipping costs, and to answer any questions you may have.  We will request final confirmation of the order before initiating the manufacturing process.