ORDER FORM |
Stone Specialties
5840 Daniels Road
Bath, NY 14810
Phone 607-776-9775 Or call to fax
Email to BGennello@direcway.com |
| SHIP TO: |
| Name: |
Business Name:
|
| Street Address
for UPS delivery: |
| City, State
Zip: |
| Delivery
Phone: ( ) |
Fax Number:
( ) |
| Email address: |
| REQUESTED
SHIP DATE: |
CHOOSE YOUR
METHOD of PAYMENT: VISA MasterCard |
| |
Account #: |
Expiration
Date: |
| |
Signature: |
| |
Address (if
different from ship to): |
| |
City, State
Zip: |
| |
Phone (if
different): ( ) |
C.O.D. (Money Order on Delivery) |
Check or Money Order Enclosed with Order |
| DESCRIPTION |
SIZE |
QTY |
PRICE
EACH |
TOTAL
PRICE |
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SHIPPING
CHARGES FOR F.O.B. Bath, NY.
will be added to invoice. |
TOTAL |
$ |
| (For more
items, please add a sheet of paper) |
THANK YOU FOR YOUR ORDER! |
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