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Purchase Order No.:

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Bill to:  
Customer No.:
Company Name:
Address:
 
City, State, Zip:
Attention:
Telephone:
Fax:
Email:
Ship to: Same as Bill To
Company Name:
Address:
 
City, State, Zip

Series No.
Key
Size
Description
Color
Price
Qty.
Total
Shipping & Handling
Merch. Total
S&H
Merch. Total
S&H
$25 or less
$8.65
$101.00-150.00
$21.00
$26.00-35.00
$9.50
$151.00-200.00
$25.25
$36.00-50.00
$11.75
$201.00-300.00
$35.50
$51.00-75.00
$14.50
$301.00-400.00
$43.00
$76.00-100.00
$17.85
$401.00-500.00
$52.00
Merch. Total
Orders under $20, add $5.00
Shipping & Handling (S&H)
Order Total

Please call office for pricing for orders over $500.

Information from Ordering Checklist
(i.e. wording, type style, color, mounting method, wood color)

Payment Plans Available!
Call 800-258-1566


Give us a call! p. 800-258-1566, p. 603-889-4126, Fax. 603-883-6395
info@zaxcorp.com

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