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Order Form
:
Please use this form to order or re-order production or prototype products.
Please select:
Prototype Order
Production Order
Estimate number:
Contact Name:
Company:
Street Address:
City, state, zip:
Telephone:
(
)
Ext.
Fax:
(
)
E-mail Address:
Website:
PO#:
Your Part#:
Ship Via:
UPS Account # (if applicable):
FedEx Account # (if applicable):
All orders are shipped FOB Laconia, NH - freight collect. Please specify preferred carrier
Date
by which the product is required:
Ship to Address
:
Check here if shipping address is same as billing
Company:
Street Address:
City, state, zip:
Attention:
Additional Information:
For initial production orders, prototypes are required on items other than sheets or RSCs
Orders will not be processed until prototypes are approved
Minimum order is $395 for production orders
Made to order prototype is available - $90 minimum charge
All orders are shipped FOB Laconia, NH - freight collect