STARK MEASURE REQUEST FORM Date: 2018-09-27 Designer: JSC Interiors Salesperson: Tenzing Nepali Phone#: Showroom: NEW YORK Client Information: Contact Person to Schedule Measure: Name: Address City NY Karvna Shuliak Name: Karvna Shuliak 9 East 71st Street Phone#: State: 10021 Zip: Email: Phone#: OCall to Schedule ONo. Just go ASAP Measure Date: By: Call: 015 Min. 030 Min. O1Hr. before THE FOLLOWING AREAS ARE TO BE MEASURED: O Bed Room(s): CeciY QGirl OffabY ONI O Master Suite: O Dressing Room: O Sitting Area: O Office: O Guest Room: O Family Room: O Sun Room: O Foyer Room: O Main Steps: O Upper Hall: O Back Steps: O Back Hall: O Closets: O Basement: O Entire: O O O O O O O O O O O Living Room: Dining Room: Library: Study Room: Den: Media Room: Billiard Room: Exercise Room: Powder Room: Maids Room: Bath(s): Other(s)J. ONo Kitchen ONo Baths + the vestibules Special Instructions: Reset Form Print Form Email 979 Third Avenue New York, NY 10022 T www.starkcarpet.com EFTA00523881