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Billing Information is same as Shipping Information

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Shipping Information

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Address:

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City:

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Payment Information

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Quantity

Name of Item

Item Number

Price Each

Extended Price

Additional Order Blanks

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Merchandise Total: $

Shipping and Handling: $

Subtotal: $

Subtract Distributor discount: $

(8.1% Washington Residence Only)  Sales Tax: $

Total Amount Due: $

Shipping and Handling Information

(Continental U.S. Prices)

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Order

Total

                                Standard                                 Express

                                 (7-10 Business Days)              (3-5 Business Days)

Up to $ 20.00                   $ 5.95                                   $ 12.95

$ 25.01 to $ 40.00             $ 7.95                                   $ 16.95

$ 40.01 to $ 75.00             $ 8.95                                   $ 18.95

$ 75.01 to $ 100.00            $10.95                                  $ 20.95

$ 101.00 to $125.00           $ 12.95                                 $ 22.95

$ 125.01 to $ 200.00          $ 14.95                                 $ 26.95

Over $ 200.00                                    8% of Order

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