Name Address City StateZip Code Country
Phone Number with Area Code
No orders processed without valid phone number
E-mail Address
DESCRIPTION  OF PRODUCT	HOW  MANY?	COST PER ITEM	ITEM  TOTAL COST
Shipping (per quote)
Subtotal
NY Residents, enter your county name  your Sales Tax Rate % and the amount
Total Cost

By submitting this order you agree to the terms and conditions of the sale, and that you have read and understand the return policies as stated on the web site. If you wish to review these policies click here  Return Policy  When you provide a check as payment, you authorize us to (1) use information from your check to make a one-time electronic fund transfer from your account, (2) process the payment as a check transaction, or (3) create and process a demand draft against your account. When we use information from your check to make an electronic fund transfer, funds may be withdrawn from your account as soon as the same day you make your payment, and you will not receive your check back from your financial institution. If your payment is returned unpaid, you authorize us to represent the check either electronically or by paper draft drawn on your account. You also authorize us to collect the returned item fee described below by presenting a demand draft against your account or by making a one-time electronic fund transfer from your account.  Please be advised civil penalties, interest, collection costs, legal expenses, attorney fees and other expenses incidental to the collection of the principal obligation may also be imposed.

                                                                        Returned item fee will be $75.00

            Signature ___________________________________________________________