Combi Cosmo DX - Parts Order Form

Charge to my credit card:
 VISA  MASTERCARD
 AMERICAN EXPRESS  DISCOVER
Card Number
Expiration Date __________ - ___________ -
____________
Cardholder’s Signature
Parts Order Form
If you would like to place an order for the replacement parts, please fill out the form below and
return to the following address:
Combi or Fax this completed form to
Attn: Consumer Affairs Department
1962 Highway 160 W, Suite 100
Fort Mill, SC 29708-8027
IMPORTANT: We must have this information to process your order:
Model Number: _________ - ______ Color & Pattern of Fabric: _____________________________________________________
Parts List for the Cosmo DX / EX only.
Price Quantity Total
1. Canopy 20.00
2. Basket 10.00
3. Standard Guardrail 15.00
4. Guardrail Cover 5.00
5. Rear Wheel Assemblies (left and right sides) 15.00/set
6. Front Wheel Assemblies (left and right sides) 15.00/set
7. Cup Holder 12.00
8. Shoulder Pads 10.00/set
9. Seat Cushion 35.00
10. Carrying Strap 12.00
Amount of Order
ADD
Shipping & Handling
Sales Tax (6%)
(SC residents only)
Total
If you need to order other parts for your stroller, please call us toll-free at
1-800-992-6624.
Shipping and Handling Fees: Add $8.00 for orders $34.99 and under. Add
$13.00 for orders $35.00 and over. Note: Additional shipping charges will apply
outside of the Continental U.S.
Combi USA reserves the right to change pricing at any time.
Ship To:
Customer Name
Street Address
Street Address
City, State, Zip
Telephone Number
081806
803-548-3663
Located on the rear right leg.
Combi USA, Inc. • 1962 HWY 160 W, Suite 100 • Fort Mill, SC 29708 • www.combi-intl.com
Consumer Affairs 1-800-992-6624
Cosmo DX / EX
Instruction Manual