ALCO P11

FAX ORDER FORM

BILL TO: Facility _________________________________ Address ________________________________ City ____________________________________ State/ZIP _______________________________ Name __________________________________ Phone ( _____) ___________________________ Fax ( _____) ___________________________ Email _________________________________ SHIP TO: (If different from Bill To:) Facility _________________________________ Address ________________________________ City ____________________________________ State/ZIP _______________________________ ATTN/PO#: ______________________________ Phone (_____) ___________________________ Fax ( _____) ___________________________ Email _________________________________ Customer # ________________________ PO # _____________________________

ALCO

UNIT

TOTAL

QTY

PART NO.

DESCRIPTION

PRICE PRICE

$

$

$

$

$

$

$

$

$

$

$

$

$

$

$

$

SUB-TOTAL $

PAYMENT METHOD (Check One)

IL STATE SALES TAX $ (If Applicable) TOTAL AMOUNT $ Plus Shipping & Handling

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Exp Date____/____ Please enter account number:

Make A Copy Of This Order Form and Fax To ALCO Sales Toll Free Fax Number 800-950-1167

Print Name __________________________________ Signature____________________________________

P11

RETURN OF MERCHANDISE Written approval with RMA number must be obtained from ALCO Sales & Service Co. for all returned merchandise. Where authorization is granted, a charge up to 30% plus freight may be made. No returns on custom-made items unless due to factory error. 30 day limit on returns. ALCO Minimum Order & Terms Policy Terms: 20 day net. ALCO has a $20.00 minimum order. Orders less than $20.00 we will add a $3.00 small order charge to process any order under $20.00 unless a credit card is used. SHIPPING/DELIVERY TIMES We make every effort to expedite your order the same day. Postage or shipping and handling will be added to your order unless you request some other arrangement. F.O.B. Shipping Point.

CONDITIONAL CONTRACT OF SALE Information herein is as supplied by the manufacturer of the item. While we believe it to be generally correct we do not guarantee it, with the exception of so state guarantees and warranties. Title of Goods is reserved in seller until entire purchase price is paid in full. In default of payment at maturity, seller may remove such goods in event this account becomes delinquent and is necessary to institute proceedings. Purchaser agrees to pay reasonable attorney fees and court costs. SPECIFICATIONS AND PRICES SUBJECT Specifications and PRICES SUBJECT TO CHANGE WITHOUT NOTIFICATION • PRICES BASED ON U.S. CURRENCY — PLUS FREIGHT F.O.B. Shipping Point. DUN & BRADSTREET Dun & Bradstreet #05-108-2337 • Federal ID #36-2768224s Illinois Resale Tax #0254-0721 S.I.C. Code 50 47 • FDA Reg 9010072 • GS-07F-0483V

ALCO PRICING POLICY We Will Not Be Undersold

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