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Central Harness Shop, LLC |
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16509 Decker Creek Drive • Manor • TX • 78653 • 1-877-784-6932 |
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O r d e r F o r m |
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SHIP TO: |
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BILL TO: |
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PAYMENT BY |
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Check |
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Credit card |
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VISA Mastercard |
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Card number |
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Date ordered |
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ITEM NO. |
DESCRIPTION |
UNIT |
QTY. |
UNIT COST |
TOTAL AMOUNT |
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SUBTOTAL |
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Shipping charges |
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Handling charges |
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Insurance |
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Ordered by |
Tax rate |
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% Tax |
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TOTAL DUE |
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SPECIAL INSTRUCTIONS |
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