Make your own free website on Tripod.com
Please print the order form below and fax to (775)898-4828

ORDER# ________________

Bill To: Ship To:

Order Date: Ship Date: Sales Rep. Ship Via: Terms:

Min.
Item No.
Description
Unit
Qty
Amount


Customer
Signature: ______________________________  Tel: ________________________ Fax: ________________ Sales Rep: ___________________

Special Instructions:






** First Order COD or Prepay, Minimum Order $500.00. Assortment Possible **