Shipping Address - PLEASE PRINT CLEARLY

First Name _____________________ MI_______ Last Name ___________________________

Company Name________________________________________________________________

Street Address_________________________________________________________________

City, State, Zip_________________________________________________________________

Telephone No. _____________________________Fax No. _____________________________

Credit Card Information - PLEASE PRINT CLEARLY

First Name _____________________ MI_______ Last Name ___________________________

VISA MASTERCARD DISCOVER AMERICAN EXPRESS - PLEASE CIRCLE ONE

Card Number__________________________________________Exp. ____________________

Card Verification Number: (On the back of your card, locate the final 3 digit number. For American Express cards,
the verification number is a 4-digit number printed on the front of your card.)_____________

Telephone No. ______________________________Signature ___________________________

Qty______ Price___________ Description_________________________________ Total_______________

Qty______ Price___________ Description_________________________________ Total_______________

Qty______ Price___________ Description_________________________________ Total_______________

Qty______ Price___________ Description_________________________________ Total_______________

California Sales Tax 8.75% ______________________

Shipping & Handling ___________________________

Total ________________________________________
3.9% Fax Order Processing fee
(multiple the total amount by 0.039)________________

Grand Total __________________________________

Shipping & Handling Fees*: .
Within the (48) USA - excluding Special & International Orders.
Up to $78.99: $24.95 - $79-$124.99: $14.95...
$125-$349.99: $24.95 - $350-$749.99: $34.95
$750 and up: Free
*See the Order page for additional terms and conditions.
*INTERNATIONAL SHIPPING
PLEASE NOTE THAT THE PRICE QUOTED FOR SHIPPING TO YOUR COUNTRY WILL NOT INCLUDE ANY DUTIES OR CUSTOMS CHARGES THAT WILL BE CHARGED BY YOUR COUNTRY. WE CAN NOT QUOTE DUTIES OR CUSTOMS CHARGES FOR YOU. WE WILL NOT UNDER ANY CIRCUMSTANCES ACCEPT RETURNS RELATING TO UNPAID OR REFUSED DUTIES OR CUSTOMS CHARGES. IF THE ITEM COMES BACK TO US, YOU WILL BE RESPONSIBLE FOR PAYING POSTAGE TO HAVE THE ITEM REDELIVERED.