Custom Quote Form

For the Southern California area only.

Please read Glass Basics-The 4 things you should know to order glass before filling out the Quotes form below or calling 55 Glass.

Name *:

Phone Number *:
( )-

Address:

City *

State

Zip Code

Email Address *:

Clear Glass

Mirror

Other

Describe if other:

Quantity:

Thickness:

Color:

Width
(inches):

Height
(inches):

Describe glass shape:
Round Diameter
Rectangle or square with square corners
Rectangle or square with rounded corners
      How to figure a radius corner dimension »
      Radius Corner Size*
     (radius size required for rounded corners)
Other
Describe if other glass shape:

Edge: Please refer to the Glass Edge Chart »

Polish Bevel (expensive) Seamed edge Other

Describe if other type of edge:

Hole(s): Yes No Qty: Size:

Will this piece fit into a frame?: Yes No

Please describe application *:

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