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Project Name
**
Dealer / Salesman
**
Dealer Email
**
Company or School District Name
**
EXAMPLE ( Northumberland County Area School District ) If Residential -- Please Put Customer Name
Customer / Bill To Address:
**
FULL ADDRESS: Street, City, State, Zip
Contact Name for Acknowledgment
Email For Acknowledgement
Contact Name for Invoice
Email for Invoice / Payment
Payment Type
*
PO
WIRE
CHECK
CC
Payment Terms
*
Full Amount
50%-50%
Ship To Same as Bill To
**
YES
NO
Ship To: Company / School Name
EXAMPLE ( Norry Middle School )
Ship To / Delivery Address:
Enter Full Delivery Address: Street, City, State, Zip
Delivery Contact Name
**
Email For Delivery
**
Phone For Delivery
**
Quote
Layout
PO
Tax Exempt
**
Yes
No
Tax Exempt Paperwork
Special Instructions or Details Important to the Order:
Submit