570 Hood Road Unit 23
Markham, ON, L3R 4G7
T: 1-888-339-9964
FAX / PURCHASE
F: 905-944-0406
sales@btnx.com ORDER FORM
Date (MM/DD/Y): _____ / _____ / _____
BILLING SHIPPING
Company: Company:
Contact name/Title: Contact name/Title:
Address: Address:
City, State, Zip: City, State, Zip:
E-mail: E-mail:
Tel: Fax: Tel: Fax:
QUANTITY ITEM CODE DESCRIPTION UNIT PRICE TOTAL
Shipping Method
UPS Ground (3-5 Days) SUBTOTAL: _____________________
Hand Delivery SALES TAX (if applicable):__________
Other: ____________ SHIPPING: ______________________
Orders over $500.00 qualify for free shipping. TOTAL: _________________________
TERMS AND CONDITIONS
Payment term is net 30 days of receiving product. If you are unsatisfied with your product in the first 30 days you are not obligated to pay.
Please contact your local representative to arrange pickup, replacement, or for any other questions regarding terms and conditions.
x___________________________________ x___________________________________
Print Name Signature
To have your order invoiced you must already have established credit with us. To pay by credit card please call 1-888-339-
9964 ext 201. VISA and MasterCard is accepted. To pay by cheque send payments to 570 Hood Rd. Unit 23, Markham ON,
L3R 4G7. Please specify how you would like to receive your invoice:
Fax
E-mail
Mail Thank you for your business
570 Hood Rd. Unit 23, Markham ON, L3R 4G7 www.btnx.com
1-888-339-9964