(1) Print this form using your browser's print option under File.
(2) Gather the information.
(3) Call us or fax the information.
(4) We verify with you that everything is correct.
(5) Order is processed.
ICE MACHINE PARTS
3750-A Airport Blvd. PMB 241
Mobile, AL 36608
Phone: (251) 343-3725 Fax: 251-343-7388
www.icemachineparts.com

Order Form



1. Item List: _______________________________________________________

_________________________________________________________________

_________________________________________________________________

_________________________________________________________________

_________________________________________________________________

_________________________________________________________________

_________________________________________________________________

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2. Service Manual! (Yes , No) $10.00 _________________
   
Subtotal : _________________
   
3. If located in Alabama add 4 % sales tax     Tax : _________________
   
4. Shipping Charges (See Below) Estimation : _________________
   
5. With estimated shipping your total will be: Total : _________________


UPS Ground, Priority Mail:   $0.30/lb. plus     $7.00
2nd Day Air: $0.85/lb. plus   $15.00
Standard Next Day Air: $2.15/lb. plus   $23.00
Alaska & Hawaii: $3.25/lb. plus   $23.00
Canadian Orders: $2.05/lb. plus   $30.00
International Orders: $3.25/lb. plus   $80.00






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ICE MACHINE PARTS
3750-A Airport Blvd. PMB 241
Mobile, AL 36608
Phone: (251) 343-3725 Fax: 343-7388
www.icemachineparts.com

Order Form



Billing Address

6. Name: _________________________________________________________

7. Address: _____________________________________________(no P.O. box)

__________________________________________________________________

8. Phone: ( ) __________________ Fax: ( ) ____________________

9. E-mail: _________________________________________________________

If payment is by credit card answer 10-13.

Credit Card Details

10. Credit Card Type: Circle one (Visa, Master Card, American Express).

11. Name on Card: __________________________________________________

12. Credit Card #: ___________________________________________________

13. Expiration Date: __________________________________________________

Shipping Instructions

14. Ship-to Name: ___________________________________________________

15. Ship-to Address: _______________________________________ (no P.O. box)

________________________________________________________________

16. Ship-to Phone #: __________________________________________________