PRINT
THIS FORM AND THEN FAX, EMAIL OR SNAIL-MAIL IT TO:
4P Company of America, LLC
1403
Johnson Street
P.O. Box 709
Tallulah, LA
71282
(318) 574-3464
Phone or Fax
Email: fourp@bayou.com
NOTE:
There is only ONE shipping and handling charge when ordering multiple
items.
Please contact
us with any questions when ordering multiple items.
<<< Contact 4P Company for Shipping
Cost outside of USA >>>
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Order
Date _____
/ _____ / _____ |
SHIP
TO: | |||||
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Address: | ||||||
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City,
ST, Zip: | ||||||
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E-Mail
Address: | ||||||
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Indicate
Payment Type |
Indicate
Credit Card Below |
Card
Holder's Name | ||||
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Personal
Check _____
Money Order _____ |
MasterCard
or Visa |
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Telephone
Number
|
Place
Credit Card No. Below ____________________________ |
Expiration
Date (Month/Yr) ______
/______ | ||||
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Quantity |
Product
Description |
Model
of PPC |
Fabric |
Price
each |
Extended
Amount | |
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Full
Protection Cover with 500 denier CORDURA |
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Black |
$260.00
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Full
Protection Cover with 500 denier CORDURA |
Sky
Trek |
Black |
$275.00
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Please
include your PPC Manufacturer
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Oversize
Chute Bag |
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$55.00 |
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Handy
Bag |
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$35.00 |
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Padded
Helmet Bag |
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$30.00 |
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Dual
filter covers |
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$15.00 |
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SUBTOTAL |
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Louisiana
State Sales Tax 8.5% (LA Orders Only) |
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(See:
Ordering & Shipping Information) SHIPPING & HANDLING |
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Order
Total |
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THANK
YOU! Please make payment payable to: 4P Company of America,
LLC