FIRST NAME:
LAST NAME:
COMPANY NAME:
SHIPPING ADDRESS: (this should be a physical address)
CITY: STATE: ZIP Code:
Mailing Address:
City: State: Zip Code:
PHONE:
E-Mail Address:
PRICES - While we make every effort to show the current price on the product page, prices are subject to change, and orders are not final until we accept them by sending you an e-mail confirmation, and by actually shipping you the item.
ITEM 1:
QUANTITY: AMOUNT:
ITEM 2:
QUANTITY: AMOUNT:
ITEM 3:
QUANTITY: AMOUNT:
ITEM 4:
QUANTITY: AMOUNT:
Merchandise Total (total cost of all items above):
- Cash Discount (Subtract) 5 Percent Discount IF YOU ARE PAYING BY CHECK OR MONEY ORDER (any amount), Or Wire Transfers (value for wire transfers must be over $500.00) (take merchandise total (excluding any SEPARATELY LISTED shipping charge) x .05): (Click on the payment information link for details)
Order Sub-Total - (This is merchandise total less any discount taken):
+ (Add) Sales Tax (ARIZONA RESIDENTS ONLY, then 8.7% x Order Sub-Total):
+ (Add) Any shipping charges listed on web page (IF PRICE SAYS DELIVERED then there are none for locations in U.S. 48 states with normal delivery access):
ENTER YOUR TOTAL ORDER COST:(Total Order Cost is: Order Sub-Total + sales tax (if applicable - AZ residents only) + total shipping charges):
Shipping charges shown are for shipments to locations within the U.S. 48 states with normal delivery access. For shipments with special delivery requirements and shipments to Alaska, Hawaii, all U.S. Territories including Puerto Rico, Canada and all other countries, please e-mail us.
TYPE SPECIAL INSTRUCTIONS HERE:
(Such as requesting our bank information for payment by wire, or
requesting to pick up a truck shipment at the terminal, or
let us know here what special shipping services you have paid for above, or
specify if you are paying by cashiers check and taking our 5 percent discount, or
any other special instructions).
Credit Card Number:
Expiration Date:
Security Code*:
*The Security Code is the 3 digit number on the back of the credit card by the signature line on Visa, Mastercard, and Discover Card, and the 4 digit number on the front of American Express.
Customer Signature:
We make every effort to keep prices current and correct as shown on our product pages. Prices do change frequently however; the total cost is not finalized until we have sent you a copy of your receipt confirming the items and pricing for the order. To make sure you are viewing current as possible information and pricing, click on the refresh button on your browser after you have gone to the page, or directly type in our web address for that particular page, or go to our main page: www.wikco.com and use our index.