|
QTY |
HIGH PRES. |
SWT/SOUR |
PRODUCT |
( IF OTHER:) |
|
Example: |
HP |
Sweet |
-Other- |
Condensate |
| 1. |
HP |
|
|
|
| 2. |
HP |
|
|
|
| 3. |
HP |
|
|
|
| 4. |
HP |
|
|
|
| 5. |
HP |
|
|
|
|
* EMERGENCY NUMBER : |
|
| POSTS & HARDWARE | |
| Quantity | Type |
| Hardware Only | |
|
Additional Information / Comments |
|
|
|
|
|
* Please be as complete as possible |
| BILLING | ||
| * Company Name | ||
| PO or AFE # | ||
| Charge Code | ||
| * Contact Name | ||
| * Email Address | ||
| * Phone and Fax | ||
| * Invoicing Address | ||
| Address (cont.) | ||
| City | ||
| Province | ||
| Postal Code |
| SHIPPING | |
| * Attention | |
| * Courier | |
| Phone | |
| * Street Address | |
| * Address (cont.) | |
| * City | |
| * Province | |
| * Postal Code |
Thank you for ordering from I-DENT.
You will receive confirmation from your Sales Representative shortly.
If you do not receive confirmation within 48 hours please contact us directly.