Aquamatic swimming pool covers

Thank you for your interest in Aquamatic Cover Systems' swimming pool safety covers.
In order to expedite the processing of your order, please complete the form below.

First Name :

Last Name :

Address:

City, State:

Zip Code :

Telephone

Email:

Builder's Name :

Builder's Company :

Builder Address :

Builder City, State :

Cover Type:

HydraMatic:

EZCover:

Mechanism Type:

Recessed:

Track Type :

Under:

Deck Mount:

Top:

Flush:

Inwall Receptor Type (choose one): #1: #2: #3: #4: #5: #6:

Indicate total linear feet required:

Pool Location:

Indoor:

Outdoor:

Pool Size/Tile to Tile:

Pool Type (if applicable):

Track to Track Spacing:

Track Length:

Drive End Position (standing behind unit looking at pool): Right: Left:

Hydraulic Hose Length:

Lid Length:

Lid Type:
Aluminum: Standard: Powder Coat Color:
Composite:            Gray: Charcoal: Tan: White: Brown: Terra Cotta:
Composite Bench: Gray: Charcoal: Tan: White: Brown: Terra Cotta:

St. Steel Brackets: How Many?
St. Steel Pans: How Many?
St. Steel Clips: How Many?

Cover Color:

Navy Blue #1 : Turquoise #4 : Tan #7 : Char. Gray #10 :

Royal Blue #2 : Teal #5 : Brown #8 : Gray #11 :

Light Blue #3 : Green #6 : Black #9 :

Misc:

Submitted by:

Date: