100 Eagle Dr, Galesburg, MI 49053
(269) 665-9630
Fax: (269) 665-9631

ORDER FORM

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Part#	Description	Quantity	Cost Each	Total









Shipping Call or write for shipping quote. Orders to areas outside the Continental U.S. require special shipping charges. Write or call for current rates.		Total
		Tax ( MI Residents) 6%
		Shipping & Handling
		Grand Total

**We also accept the following Credit Cards**
Visa, MasterCard, Discover
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Other Notes:

Please note that while we attempt to keep all of our prices current, they are subject to change.

For the utmost in security, we invite you to print this form from your browser. We suggest that you set your printer scale at about 90%, or download and save the form in text format. You can mail the completed form or fax it to us at (269) 665-9631. We will be happy to process your order.

ORDER FORM

Shipping

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