Please Print & Mail To:
O.E.M. Ltd
850 Industrial Ave. U-11 Ottawa, Ont. K1G-4K2
| Item |
Product No. |
Qty |
Price @ |
Ext. Price |
| 1 |
1 |
1 |
1 |
1 |
| 2 |
1 |
1 |
1 |
1 |
| 3 |
1 |
1 |
1 |
1 |
| 4 |
1 |
1 |
1 |
1 |
| 5 |
1 |
1 |
1 |
1 |
| 6 |
1 |
1 |
1 |
1 |
| 7 |
1 |
1 |
1 |
1 |
| 8 |
1 |
1 |
1 |
1 |
| 9 |
1 |
1 |
1 |
1 |
| 10 |
1 |
1 |
1 |
1 |
| A: Total Before Tax |
1 |
| B: Shipping Charge |
1 |
| C: Total A + B |
1 |
| D: GST 7% of C |
1 |
| (Ontario Residence
Only) E: PST 8% of C |
1 |
| Total: |
1 |
Items A, B, C, D, E are optional we will notify you via e-mail on the total price before shipping.
| Last Name: |
First Name: |
| Company Name: |
| Address: |
| City: |
Prov: |
Postal Code: |
| Tel: |
Fax: |
E-Mail: |
|
| CREDIT CARD INFORMATION |
| Type: |
Card No. |
Exp. Date: |
| Name On Card: |
| Please Sign: |
| Certified Check Or Money Order Enclosed ________ |