Printable Order Form for J&R Engineering

Purchase Order for J&R Engineering PO # Date:

Order By Phone	SHIP TO ADDRESS: Name: ________________________ Street: ________________________ City:__________________________ State/Prov/Zip:__________________ Phone # : (_____) _______________ E-mail : _______________________ Fax # : (_____) ________________	BILLING ADDRESS: (if different) Name: ________________________ Street: ________________________ City:__________________________ State/Prov/Zip:__________________ Phone # : (_____) _______________ E-mail : _______________________ Fax # : (_____) ________________
1-978-249-9241 7:00 AM - 7:00 PM EST
Order By Fax
1-775-667-0279 24 hours-7 days/week
Order By Mail
J&R Engineering. PO Box 77 Athol, MA 01331

Item#	Description	Qty	Price Each	Total

PAYMENT METHOD __ Open Account __ Check / Money Order __ COD or Credit Card using	Merchandise Total	.	.
	Sales Tax (5% MA only)	.	.
	Shipping (chart below)	.	.
	Additional Charges	.	.
	Grand Total	.	.

Purchase:		Shipping:
Up to $200.00		add $8.00
Over $200.00		add $10.00
Power Checkering System		add $15.00
Additional Charges
3 Day Select		add $6.00
2nd Day		add $10.00
Overnight		add $20.00
COD		add $9.00
All shipping is via UPS unless specified

Make Checks Payable to J&R Engineering All Prices on this website supersede previously published prices Thank You for Your Order Did you remember to: 1. Include your phone #. 2. Include your check. 3. Check your shipping address
J&R Home Page (www.gis.net/~doiron) E-mail J&R (jandrengineering@hotmail.com)