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Campus Products Inc.
(866) 912-3469 www.cpishine.com
Customer Signature:
ORDER FORM
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BILLING ADDRESS (please print): SHIP
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FAX YOUR COMPLETED ORDER TO:
(905) 829-9914
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Credit
Card
Number
Credit Card Account Number
Expiration Date
PAYMENT METHOD
Quantity
Item
Description
Unit Price
Total
CPIGRAN
20 lb. airtight bucket, vegetable base granulate
$169.00
CPIUVC
9 watt UVC germicidal lamp
$141.00
CPIBUS-P
Custom cutlery catch bin with perforated insert for granulate
recovery
$46.00 (unit)
Subtotal
Tax (Canadian orders)
Balance Due
*not including
shipping charges*
LL100D-9
White cotton inspector gloves with grip dots for handling cutlery
and polishing glasses (priced per dozen)
$35.00
SHIPPING INFORMATION
Actual ground, shipping charges will be billed to your credit card unless
shipping account number provided below.
UPS Account #:
Fed-Ex Account #: