Purchase Order

First Name

Last Name

Company Name

Phone Number

Delivery Address

City

State

Zip

Description of Item(s) Ordering:

Quantity1

Quantity2

Quantity3

Delivery Method:

Local Pickup Local Delivery (within 75 miles of Sandpoint) Freight

Accessorial Services:

Accessorial Services

Residential Delivery Liftgate Delivery/Hand Unload

Payment Method:

Payment Method

Credit Card (subject to a 3% surcharge) Check

If you are tax exempt, please provide a copy of your ST-101:

ST-101

Customization Requests

Additional Comments or Special Instructions

I certify that I have read and agree to the Terms & Conditions.

I understand that a 20% down payment will be invoiced up front and the balance will be payable upon completion.

Signature:

Signature typed

Today's Date

Signature