18295 Lexington Avenue
Reford, MI 48240
313-408-8630
Day Phone

sharonsewsew@att.net
313-537-5036
Evening Phone

Name: _______________________________________________________Date: _________________
Address: _______________________________________________________Phone: ________________
City/State/ZIP: _______________________________________________________Latest Delivery Date:
Email: _______________________________________________________ ________________

Quantity
Item/Description
Price each
Total
 
 
     
 
 
     
 
 
     
 
 
     
 
 
     
 
 
     
 
 
     
 
 
  Subtotal  
      Michigan residents please add 6%

Shipping & Insurance Charges
          If order total is:
      Under $100 ------------- $20.00
      $100 - $300 ------------ $25.00
      $300 - $400 ------------ $30.00
      $400 - $500 ------------ $35.00

   For orders over $500 and Expedited Shipping, buyer will be billed actual shipping costs.

Sales Tax

+ Shipping

Total Due

Less Deposit

Balance Due