COMBI International Corporation • 189-199 Easy St. • Carol Stream, IL 60188 • www.combi-intl.com
Customer Service 1-800-992-6624 • 10:00 a.m. - 5:00 p.m. Central Standard Time • Monday - Friday
Parts Order Form
If you would like to place an order for the following parts, please fill out the form below and return it to the
following address:
COMBI International Corporation
or
Fax this completed form to us at
Attn: Customer Service Department
189-199 Easy Street
Carol Stream, IL 60188
IMPORTANT
:
We must have this information to process your order:
Model Number: 4100 - ____ Color & Pattern of Fabric: __________________________________________
Parts List
for the Savona
™
PM (4100 Series) only.
Price
Quantity
Total
1. Acoustic Canopy
$ 35.00
2. Basket 20.00
3. Seat Cushion
30.00
4. Kids Tray
15.00
5. Shoulder Pad Set
5.00
6. Perfect Match™ Guardrail
10.00
7. Perfect Match™ Car Seat Canopy
8.00
8. Perfect Match™ Car Seat Cover
12.00
9. Rear Wheel Assemblies
(left and right sides)
20.00/set
10. Front Wheel Assemblies
(left and right sides)
20.00/set
11. Acoustic Canopy Speaker Set
10.00
12. Cupholder
8.00
Amount of Order
ADD
Shipping & Handling
Sales Tax (7.25%)
(IL residents only)
Total
If you need to order other parts for your stroller, please call us
toll-free at 1-800-992-6624.
Shipping and Handling Fees:
Add $5.00 for orders $34.99 and under.
Add $10.00 for orders $35.00 and over. Note: Additional shipping
charges will apply outside of the Continental U.S.
Ship To:
Customer Name
Street Address
Street Address
City, State, Zip
Telephone Number
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Charge to my credit card:
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VISA
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MASTERCARD
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AMERICAN EXPRESS
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DISCOVER
Card Number
Expiration Date
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Cardholder’s Signature
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Check enclosed
9/5/2003
630-871-0606
Savona
™
PM
4100
Acoustic Canop
Perfect Match
™
Stroller
Patent Pending
Located near the rear right leg.
