|
|
Contractors Advantage
Order Form
PRINT OUT TO FAX TO 1-800-775-1529
OR SEND TO 2221 PEACHTREE Rd D233 ATLANTA GA 30309
|
Company Name:_________________________________________________________
Your Name:_____________________________________________________________
Address: ________________________________________________________________
City: ___________________________ State: ____________ Zip:_________________
Phone: ______________________________ Fax:______________________________
Email: _________________________________________________________________
Shipping Address if Different:_____________________________________________
City: ___________________________ State: ________ Zip:________________
|
Product Name
|
Quantity
|
Price Each
|
Total Price
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Special Promotional Credits allowed
|
|
($ )
|
|
Subtotal
|
$
|
|
Shipping and Handling per Order
|
$ 14.95
|
|
Georgia Resident Tax Please add 8.0%
|
$
|
|
Total Order
|
$
|
Method of payment:
Visa [ ] Master Card [ ] American Express [ ] Discover [ ]
Name on Card: ___________________________________________
Card Number: ____________________________________________
Expiration Date: ________________Security Code _______________
Billing Address of Card Holder if Different than above: ________________
____________________________________________________________
|
|
To Order 