Action Industries Accessories : Page 18

SALES ORDER ph 800-321-1130 f 888-321-1130 Bill To: Company Address 1 Address 2 City: State: Contact: Account # Phone # Payment Bill My: Acct# PO# Shipping FedEx: Carrier: Other: Next Day 2nd Day Ground UPS: Next Day 2nd Day Ground PPY & ADD/COLLECT/3RD PARTY Part# 1/2” Splice & install 1/2” Splice & install 1/2” Splice & install 1/2” Splice & install 1/2” Splice & install 1/2” Splice & install 1/2” Splice & install 1/2” Splice & install 1/2” Splice & install 1/2” Splice & install 1/2” Splice & install Date to be shipped: Job Name (if applicable): Additional Notes: If you have not received confirmation of your order within two hours please call 800-321-1130 Qty Cut To Special Instructions Unit Price Total Price Exp. Zip: Fax# Ship To: Company Address 1 Address 2 City: State: Phone # Date: Zip: Fax#

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