Please fill out the form and one of our consultants will be contacting you shortly. Thank you for your interest in our blast rated structures. We look forward in talking with you.

Name: Company Website	Phone: Address Email:
Project Requirements
Blast Rating Required: Please Select 5 PSI 8 PSI 8+ PSI	Fire and Gas Detection: Please Select Yes No
What is the approximate sq/ft required:	Will the structure be placed on a Class 1 Division 2 area: Please Select Yes No
CanadaBlast products interested in: 12X40 Warehouse 12X40 Lavatory 16X40 Open Concept Multi Module Complex Custom Structure	What is the planned use of the structure:
Are you looking for: Lease Purchase Both	Preferred Method of Contact Please Select Phone Email
*Comments/Specifications	How did you hear about us: Please Select Billboard Magazine Ad Website Other

1600, 503 - 3rd Street SW Calgary, AB T2P 3E6 | MAIN: 403 244-7441
FAX: 403 244-7443 | TOLL-FREE: 1 877 441-9233 | info@paramountstructuresinc.com

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