6348 - C Burnt Poplar Road

Greensboro, NC 27409
Phone: 336.851.1351
Fax: 336.851.6728
www.executivefurnitureleasing.com

Date:
Delivery/Pick-Up/Adjustment: Requestor Name:
Community: Company:
Unit Address: Phone:
Move-In: Move-Out: Fax:

Bed Sizes
Size: 1x1 2x2 3x2 Other: Master: King Queen Twin
Furniture Style 2nd: King Queen Twin
Standard $ 3rd: King Queen Twin
Pine Washer & Dryer
Urban & Maribel
Yes $
Executive $
No
Carlyle - Black
Pet
Kira - Brown
Yes Type:
Housewares Package
No
Yes $
No
Extras
DVD Player
42” TV 1 2 3 $
1 2$
32” TV 1 2 3 $
Microwave $
26” TV 1 2 3 $
King Upgrade $
Welcome Basket $
Writing Desk w/ Chair $
Starter Kit $
Sleeper Sofa $
Other $
Recliner $
Barstools $
2 3 4
Special Instructions:

For Office Use Only

Cost: Tax (6.75%): =Total
One Time Fees: Delivery Fee:
Received On: By: Delivery Date:

Please send all orders via fax or email

Fax: 336.851.6728
weslei@corporate-accommodations.com or rebecca@corporate-accommodations.com