Tandem Associates LLC, P.O. Box 245, Whitmire, SC 29178-0245
E-mail: tandem@tandem-associates.com
Marx Signs Order Form
Name __________________________________________________________
Address __________________________________________________________
City, State, Zip____________________________________ , _______ , ____________
SHIPPING Address__________________________________________________________
(if different) __________________________________________________________
City, State, Zip____________________________________ , _______ , ____________
Phone: Home (_____) - ______ - ________ Work (_____) - ______ - _________
Fax # (_____) - ______ - ________ E-mail ________________________
Payment: Personal or business check ______ ; Money order or certified check _____

Part #DescriptionQuant.PriceTotal Price
     
     
     
     
     
     
     
     
     
     
     
     
Insurance:
--- $1.65 for orders under $200
Shipping Rates for US Shipments:
--- $4 for orders under $5
--- $6 for orders more than $5
International orders: please contact us for our rates.
Sub-total  
6% SC Sales Tax  
Insurance  
Shipping  
TOTAL AMOUNT  

Signature ________________________________________________ Date _____________