74763
(12/04)
© 2004 Electrolux Home Care Products Ltd.
Printed In China
SOLD TO:
Name
Address
City
State
Zip
Telephone (Day)
Telephone (Eve)
Fax
SHIP TO:
Name
Address
City
State
Zip
Telephone (Day)
Telephone (Eve)
Fax
PAYMENT (no C.O.D. Orders)
Check or money order. Do not send currency.
VISA
DC
MC
AMEX
ACCT. NUMBER
EXPIRATION
DATE
SIGNATURE (full name as shown on acct.)
IMPORTANT:
Be sure to include your model, type, and serial
numbers. These numbers may be found on the rating plate.
TO ORDER:
By Phone: 1-800-282-2886
Hours: Call Monday-Friday
8:00 am - 7:30 pm CST;
Saturday 10:00 am - 6:30 pm CST
(Please call the same number for
answers to problems or questions
in the USA and Canada)
En Mexico llame al:
(55) 5343-4384
By FAX: 1-309-589-7583
By Mail:
Simply fill out this Order Form.
Please be sure to include day and
evening phone numbers.
ONLINE
www.eureka.com
Payable to Electrolux Home Care Products North America
The Eureka Company
P.O. Box 3900 • Peoria, IL 61612
MODEL
TYPE
SERIAL
NUMBER
NUMBER
Genuine Eureka Parts
Part No.
Qty. Price
(USD)*
Total
WATER TANK ASSEMBLY
74730
17.99
RECOVERY TANK ASSEMBLY
74409
27.99
NOZZLE ASSEMBLY
74418
14.99
NOZZLE BRISTLE STRIP
74747-355N
3.99
DETERGENT TANK ASSEMBLY
74430
5.99
32 OZ. CARPET & UPHOLSTERY
62383
5.99
SHAMPOO
64 OZ. CARPET & UPHOLSTERY 60170A
10.99
SHAMPOO
TOTAL
(*prices subject to change without notice)
TAX
(add state tax & local taxes as required by law)
POSTAGE & HANDLING CHARGE
(within USA)
$5.50
T O T A L E N C L O S E D
