Service Parts Order Form
Fax to 559-263-9631
Please fill out completely
Date: ______________________________
Account: ___________________________
Bill to: _____________________________
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Ordered By: _________________________
Your Fax No.: _______________________
Ship to: ____________________________
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Purchase Order Number ______________
**All orders MUST have a Purchase Order Number
Ship VIA___________________________
**Fed Ex shipments require Fed Ex account number
Part Number Description Quantity Price
All backordered parts will be shipped when available via the same ship method as original order unless noted
below:
- Ship complete order only - no backorders
- Ship all available parts and contact customer on disposition of backordered parts
- other (please specify)
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