 |
DATE: ________________ |
|
DATE: ________________ |
| BILL TO: (Please Print/Type) __ Home __ Business | SHIP TO: (Please Print/Type) __ Home __ Business |
Name _________________________________ Firm/School ____________________________ Address _______________________________ Address _______________________________ City _________________________ State _____________ Zip _______ Phone ( ) ______ - _________ Ext. _______ Fax ( ) ______ - _________ Email __________________________________ |
Name _________________________________ Firm/School ____________________________ Address _______________________________ Address _______________________________ City _________________________ State _____________ Zip _______ Phone ( ) ______ - _________ Ext. _______ Fax ( ) ______ - _________ Email __________________________________ |
| PAYMENT METHOD |
We accept the following Credit Cards (check one) __ MasterCard __ Visa __ American Express __ Discover *Sorry, No C.O.D. Orders ( For Company or Personal checks allow minimum 14 days for bank clearing before shipping) Credit Card Account Number Expiration Date ____ ____ / ____ ____ Signature
(Required) ____________________________ |
| Stock Number | Qty | Description | Price Each | Total |
| 1 | |||||||
| 2 | |||||||
| 3 | |||||||
| 4 | |||||||
| 5 |
| For Orders Totaling | UPS Ground | Merchandise Total |
|||
| Up to $50.00 | $7.75 | ||||
| $50.01 to $75.00 | $9.75 | Shipping
& Handling |
|||
| $75.01 to $100.00 | $11.75 | ||||
| $100.01 to $200.00 | $14.05 | Subtotal | |||
| $200.01 to $300.00 | $16.55 | ||||
| $300.01 to $400.00 | $18.55 | Texas
Destinations Add applicable Sales Tax |
|||
| $400.01 to $500.00 | $20.55 | ||||
| Special
Instructions:
|
TOTAL AMOUNT |
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| Note: This shipping schedule does NOT apply to Astronomical Telescopes and Accessories. |
| Analytical Scientific, Ltd., 11049 Bandera Rd. San Antonio, Texas 78250 |
| Phone: 210-684-7373 | Fax: 210-520-3344 | www.analyticalsci.com | sales@analyticalsci.com |