Ship To: Name Company Name Please Use Area Code xxx-xxx-xxxx Daytime Phone Fax Email address Street Address Street Address City State Zip/postal Code
Select from one of the following payment options: Pre-established Web Account Check or money order prior to shipment, via US Mail. VISA MasterCard Discover Card American Express Fax credit card information toll free to: 1-888-ACE-FAX1 (888-223-3291) Card #: Exp. Date: Name: (as it appears on card) Mailing Address City State Zip/postal Code
Card #: Exp. Date: Name: (as it appears on card) Mailing Address City State Zip/postal Code
Merchandise total Shipping & Handling: $14.99 or less $6.50 $15.00-29.99 $8.00 $30.00-49.99 $10.00 $50.00-74.99 $12.50 $75.00-99.99 $15.00 $100.00-124.99 $17.50 $125.00-174.99 $22.50 Over $175.00 Calculated $5.00+ 5.0% of total. Some large items maybe shipped via common carrier, at our discression.
Amount of purchase: ${Sub_Total}
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