| Parts Order Form |
Fax to:
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Optimus Fax No. 901-794-3884 |
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| Company Name________________________________________ |
Date___________________ |
| Address______________________________________________ |
Phone__________________
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| City, State, Zip_________________________________________ |
Fax____________________ |
| Order Placed by___________________ PO No_______________ |
Opt. Cust No.____________ |
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| 3rd party shippers assumes all responsibilty for filing lost or damaged claims.
Carrier ancillary charges will be billed to you
Ground Freight Prepaid on orders of $500 Net or more
We will ship any order regardless of size (However, a $5.25 minimum order fee will apply for any order under $20 after all discounts.)
All orders over $20.00 are charged a $2.50 fee. Stock items ordered by 1:30 PM central time are shipped same day.
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Optimus No. |
Description |
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Comments & Special Instructions:
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Different "Ship To" Address (UPS adds an additional & 2.40 for residentual delivery)
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__________________________________________ |
__________________________________________ |
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| You MUST fill out all of top header information, then quantity,
and Optimus Item Number! |