Shipping Order Form
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Shipping Order # ____________
Facility: | Etiam justo. |
Attn: | Hadrian Lawes |
Address: | 3 Donald Circle |
Suite: | |
City/State: | Dallas, Texas |
Zip: | 75397 |
Phone: | (27) (8) 8060909 |
Name: | Hadrian Lawes |
Attn: | |
Address: | |
City/State: | |
Zip: | |
Phone: | |
Fax: |
Shipping Information |
Ship Via: |
⬜ UPS Next Day | ⬜ FedEx Next Day |
⬜ UPS Next Day Saver | ⬜ FedEx 2nd Day |
⬜ UPS 2nd Day | ⬜ Courier |
Box Size: |
⬜ Small box (up to 5 liquid) 48 hour | ⬜ Large box (11-50 liquid) 63 hour |
⬜ Medium box (6-10 liquid) 72 hour | Deliver on: Tuesday, September 18, 1979 |
Special Instructions: Praesent lectus. Vestibulum quam sapien, varius ut, blandit non, interdum in, ante. Vestibulum ante ipsum primis in faucibus orci luctus et ultrices posuere cubilia Curae; Duis faucibus accumsan odio.
QTY | PRODUCT CODE | DESCRIPTION | VOLUME | UNIT PRICE | TOTAL |
RV-010150 | Renovo | 1.5cc | |||
RV-010300 | Renovo | 3.0cc | |||
RV-010500 | Renovo | 5.0cc | |||
COMP-RV-010150 | Renovo | 1.5cc | |||
COMP-RV-010150 | Renovo | 3.0cc | |||
COMP-RV-010150 | Renovo | 5.0cc |
Purchaser's Email:
Date:
Order Received by:
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