Page 594 - Buyers Guide Interactive Catalog 2018-19

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IFNADXE XF O R M
BU ZL | KOCH Supplies • 800-456-5624 • www.bunzlpd.com • FAX 800-329-5624 • email: [email protected]
FAXORDER FORM
Bill To ____________________________________________ ____________________________________________ ____________________________________________
Ship To ____________________________________________________ ____________________________________________________ ____________________________________________________
FAX TO:
800-329-5624
Phone ____________________ Fax ___________________ Purchase Order No. __________________________________________
Contact ____________________________________________
FREE* SHIPPING
For orders over $400
*Some items may not qualify. See restrictions below.
ITEM NO. PRODUCT
CreditCard#___________________________________________________ CreditCardExp._________________________ CVV#_____________
For your convenience, we have made ordering simple by accepting all major credit cards including Discover, American Express, Visa and MasterCard. We even accept payments via Telecheck.
QTY UNIT COST
LINE TOTAL
*FREE SHIPPING does not include UPS Next Day Air, UPS 2nd Day
or UPS 3rd Day Select. Certain items may not qualify. This offer is good only on orders shipped UPS Ground in the 48 contiguous states. Based on dimensional weight, we will determine the most efficient means of shipment, either UPS or LTL. Products may ship by truckline.
ORDER TOTAL**
**TAXES WILL BE ADDED TO ORDER TOTAL.
New Address:
_____________________________________ _____________________________________ _____________________________________
Additional Contacts: ________________________________
Phone: ____________________ Fax: ___________________ Email Address: _____________________________________
If you would like to receive EXCLUSIVE INTERNET OFFERS, be sure we have your email address!
that would like to be added to our mailing list
________________________________
________________________________
Please help us keep your information up to date.
INDEX
PRICES ARE SUBJECT TO CHANGE — VISIT OUR WEBSITE FOR CURRENT PRICING. FAX FORM
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