TM WOOD PRODUCTS MANUFACTURING, INC.

FIREPLACE CABINET ORDER FORM

Effective date August 2002 through July 2003

Select a Model/Style ____________________

Select a Wood ____________________

Select a Finish ____________________

Please include following information:

Firebox Mfgr. ____________________

Firebox Model ____________________

Top, Rear or Ventfree ________________ (Venting)

Step 1 (Size and Clearance for Firebox)

Box Width "W" ______

Box Height "H" ______

Box Depth "D" ______

Box Back Width "BW" ______

Top Venting "FID" ______ (If Apply)

Step 2 (Determining Filler Size, ie Marble, Tile, etc.)

Filler Opening is based on overlapping firebox or framing around overall dimensions

Filler Opening Width ______

Filler Opening Height ______

Filler Thickness/depth ______

Step 3 (Determining finished Opening of Cabinet)

Cabinet Opening is determined by overlapping Filler overall dimensions 1/2"

Opening Size: A (Opening Width)=_____ B (Opening Height)=_____ CID (Inside/Box Depth)=_____

If you are using a corner application, depth will be determined by TM

(Any additional requirements must be listed below)

Overall dimensions are proportionate to opening sizes unless specified otherwise

Store Name____________________________ Contact Name____________________________

Purchase Order #_______________________ Tag Name________________________________

Store Phone #__________________________ Store Fax #_______________________________

22900 HOOVER ROAD WARREN, MI 48089

PH. 586 427 2364 FX. 586 427 5617