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Customer Information | |
| Name: | ||
| Address: | ||
| City State, Zip: | ||
| Phone Day: | ||
| Phone Night: | ||
| E-mail: |
Please print this page and use as a shipping form (To go back a page click here)
|
Customer Information | |
| Name: | ||
| Address: | ||
| City State, Zip: | ||
| Phone Day: | ||
| Phone Night: | ||
| E-mail: |
Please list all of the items in the shipment and an
estimated price(found on price page). Caps Brite
Hot Coatings, Inc. will
contact you with a total charge.
| Qty | Description of Part |
Estimated Price | ||
| Subtotal(estimated): | ||||
Customer is responsible for return freight.
Caps Brite Hot Coatings, Inc. reserves the right to modify pricing based upon physical examination the item in question.
Color Choices:
| Cermakrome | High Heat Black | Cast Iron Grey | Stainless Steel | Titanium | Porcelain |
Special Instructions:
Shipping Label
