www.suntrac.com (print this form and return with meter)

Date:

SUNTRAC SERVICES, INC

Order/Estimate Form

(Please fill in the appropriate information for each shipment)

 

 

Bill to address:

Company:

Contact:

E-mail:

Address:

City:

State:    Zip:




Ship to address: Same as Bill To

Business   Residential

Company:

Contact/Technician:

E-mail:

Address:

City:

State:    Zip:

Phone / Fax Number:

 

Quantity

Description/Service

Cost

Subtotal

 

 

Please check the appropriate billing option:

Charge Credit Card

 

Purchase Order

Call for Payment

Visa  MasterCard  Amex

 

PO#:

Card #:

 

Contact:

Exp.:

CCV:

 

Phone/Fax:

Name On Card:

 

E-mail:


SHIPPING INFORMATION: All packages will be shipped back UPS ground service unless otherwise specified.  We cannot ship to Post Office Boxes, street addresses ONLY.  Shipping charges will vary quantity, as to item(s), weight, size and destination.

 

1818 EAST MAIN STREET
(281)338-2133

Email: sadie@suntrac.com

LEAGUE CITY, TX 77573
FAX: (281)338-2136