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STRAIGHT QUOTE AND ORDER FORM Note: Please read the entire form carefully! RETURN TO HOME: CASTERSUPPLY.COM QUOTATION ONLY ORDER ONLY Title: Mr. Mrs. Ms. Miss Name: Company Name (if applicable): Title (optional): Phone: Area code + number Fax: Address City: State: Zip: E-mail: Country:
STRAIGHT QUOTE AND ORDER FORM
Note: Please read the entire form carefully! RETURN TO HOME: CASTERSUPPLY.COM
QUOTATION ONLY ORDER ONLY
Title: Mr. Mrs. Ms. Miss Name:
Company Name (if applicable): Title (optional):
Phone: Area code + number Fax:
Address City: State: Zip:
E-mail: Country:
Please order/quote only the following casters or wheels,
(DO NOT SUBSTITUTE!) Quote Exact & All Exact equivalent parts
1) Manufacturer (if known):Part Number:Qty: *Price:
2) Manufacturer (if known):Part Number:Qty: *Price:
3) Manufacturer (if known):Part Number:Qty: *Price:
4) Manufacturer (if known):Part Number:Qty: *Price:
*All published prices are subject to change! We will contact you by phone, fax, or email if there are any discrepancies in your order! Shipping is additional and is not included in the price. We normally ship all orders via UPS. If you have a UPS, or Federal Express account number you wish us to use, please enter it here: Acct. # If not, we will tabulate the shipping charges and contact you with the total!
Required info: How did you find us:
Please Provide any additional information about your requirements here:
Notes:
**Before clicking submit below, please review all information above to make sure it is correct. Please DO NOT include any credit card information on this form. We will either contact you, or you can call us direct at (800) 280-9566! We accept all major credit cards! Thank you for your order!