Glastender, Inc. • 5400 North Michigan Road • Saginaw, MI • 48604-9780
800.748.0423 • 989.752.4275 • Fax 989.752.4444 • www.glastender.com
19
Bill to:
_________________________
_________________________
_________________________
_________________________
_________________________
_________________________
Ship to:
Ship Via
_________________________
_________________________
_________________________
_________________________
_________________________
_________________________
Ground _______
NDA
_______
2 Day _______
Other _______
_______________
_______________
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
________________________________
________________________________
________________________________
________________________________
________________________________
________________________________
________________________________
________________________________
________________________________
________________________________
________________________________
________________________________
________________________________
________________________________
________________________________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
Quantity
Part number
Description
Price
_____________
_____________
_____________
_____________
_____________
_____________
_____________
_____________
_____________
_____________
_____________
_____________
_____________
_____________
_____________
__________________
__________________
__________________
__________________
__________________
__________________
Parts Order Form
Special instructions:
Date:
_____________________________
Company:
_____________________________
Contact:
_____________________________
Customer #: _____________________________
Phone #:
_____________________________
Fax #:
_____________________________
Regarding: _____________
Model #:
_____________
Serial #:
_____________
If glasswasher:
Voltage: ___ 208 ___ 240
Rotation: __ CW ___ CCW
Summary of Contents for GT-18
Page 22: ......