Arbitrator One Printable Order Form


Johnson/Chadderdon Enterprises
111 North Market Street
Knoxville, Illinois 61448-1058
(309) 289-6446 (309) 289-9788

 

Print this Order Form - Fill it out - Mail or Fax it in

Name: _______________________________________________________

Address: ____________________________________________________

City, St Zip: _______________________________________________

Phone Number: _______________________________________________

Tax Number: _________________________________________________

Purchase Order Number: ______________________________________


Description_ _ _ _ _ _ _ _ _ _ _ _ _ _Price Ea _ Qty _ Amount

Master Control Box ......................$100.00 ____ ________

Two Button Switch .......................$ 60.00 ____ ________

One Button Switch .......................$ 40.00 ____ ________

14 ft. Remote reset button...............$ 12.50 ____ ________

Replacement Light Bulb (CM#12PSB) each....$ 2.00 ____ ________

Two Foot Modular Cables ...................$1.50 ____ ________

Custon Length Cables $1.50 plus $0.20 per foot....... ________

(specify lengths) __________________________ Subtotal ________

....................................tax if applicable ________

....shipping & handling (free for orders over $50.00) ___$5.00

check payable to Johnson/Chadderdon Enterprises Total ________

Thank You for Your Order - Checks or Purchase Orders Accepted