o VISA o MASTERCARD
o DISCOVER
Card Number
Expiration Date __________ - ___________ - ____________
Cardholder’s Signature
If you would like to place an order for the replacement parts, please fill out the form below and
return to the following address:
Attn: Consumer Affairs Department
1962 Highway 160 W, Suite 100
Fort Mill, SC 29708-8027
:
Model Number: _________ - ______ Color & Pattern of Fabric: _____________________________________________________
1. Canopy 20.00
2. Basket 10.00
3. Guardrail 15.00
4. Rear Wheel Assemblies (left and right sides) 15.00/set
5. Front Wheel Assemblies (left and right sides) 15.00/set
6. Stroller Pack 12.00
7. Seat Cushion 35.00
8. Carrying Strap 12.00
9. Guardrail Cover 5.00
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.
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.
Customer Name
Street Address
Street Address
City, State, Zip
Telephone Number
082907
Located on the rear right leg.
Combi USA, Inc.