Equipment and Supply Central
Toll Free: 800-352-0272
Fax Line: 800-353-3681 PO Box 320155 Birmingham, Alabama 35222
" Servicing America's Fleet of
Genuine Magline Handtrucks"
Order Form Date:
Sold
To:
Contact Name: Company:
Mailing Address:
City:State:
Zip Code:
Phone:
Fax:
E-mail:
Ship To: (if
different than sold to)
Company:
Shipping Address:
City:
State: Zip Code: Mark Order: Attention:
Specify Type of Payment: Credit Card Type of Credit Card: Credit Card No: Expiration Date:
On Account:
Shipping Information: Ship Via: (Circle or Mark one)
UPS -:Standard Ground:
Next Day
Freight Line:
Collect: (Specify freight line)
Prepaid and add/3rd Party:
Quantity
Part Number
Description/color
Price ea $
Price Ext $
This form is provided to aid in
clarifying orders, and requests, it's certainly not mandatory to use. Simply include the same information which might be pertinent.