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| Qty: ___ Item #: _________ Size: ______ Price Each: $ _____ Total: $__________ |
| Qty: ___ Item #: _________ Size: ______ Price Each: $ _____ Total: $__________ |
| Qty: ___ Item #: _________ Size: ______ Price Each: $ _____ Total: $__________ |
| Qty: ___ Item #: _________ Size: ______ Price Each: $ _____ Total: $__________ |
| Qty: ___ Item #: _________ Size: ______ Price Each: $ _____ Total: $__________ |
| Qty: ___ Item #: _________ Size: ______ Price Each: $ _____ Total: $__________ |
| Qty: ___ Item #: _________ Size: ______ Price Each: $ _____ Total: $__________ |
| Qty: ___ Item #: _________ Size: ______ Price Each: $ _____ Total: $__________ |
| Qty: ___ Item #: _________ Size: ______ Price Each: $ _____ Total: $__________ |
| Qty: ___ Item #: _________ Size: ______ Price Each: $ _____ Total: $__________ |
| Qty: ___ Item #: _________ Size: ______ Price Each: $ _____ Total: $__________ |
| Total Qty. Brushes __________ $ |
| Total Qty. Tools ____________ $ |
| Total Qty. Kits _____________ $ |
| Retail Order Sub-Total: $ |
| Wholesale Discount Brushes __________ %= $ |
| Wholesale Discount Tools ____________ %= $ |
| Wholesale Discount Kits _____________ %= $ |
| Wholesle Order Total: $ |
| MO Residents, Please add Sales Tax $__________
Unless a valid resale certificate or tax number is provided: Tax # _____________________________ |
| Add Shipping & Handling (see below) $ |
| Total Enclosed: $ |
| Payment Options: |
| Credit Cards: Visa ____ MasterCard ____ Discover ____ Check/MO ____ |
| Name on the Card: |
| Card Number:____________________________ Exp. Date __________ |
| Signature: |
|
Shipping & Handling Charges: Orders Over $100.00 Net will be shipped Freight FREE All others: Add $5.00 shipping per order and/or delivery address. |
|
Guarantee: Brushes are made in the U.S. |
|
Patrick's Ceramics, Inc., Payable in US Funds. |
| Company Name: |
| Name: |
| Address: |
| City/Providence: |
| State & Zip Code: |
| Country: |
| Phone with Area Code: |
| Fax with Area Code: |
| Email: |
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