| Marston Technical Service, Inc. 11576 Goldcoast Drive Cincinnati, OH 45249 Phone: (513) 563-8100 Fax: (513) 554-5832 |
Customer P.O. #: ______________________ Credit Card #: ______________________ Expiration Date: ______________________ |
Bill To Address: ______________________________________ ______________________________________ ______________________________________ ______________________________________ |
Ship To Address: ______________________________________ ______________________________________ ______________________________________ ______________________________________ |
| Part No. | Description | List Price | Savings | Special Price | Quantity | Extended Price |
|---|---|---|---|---|---|---|
| AFS | Air Filtration System | $0.00 | $0.00 | $0.00 | ||
| BTF | Bench Top Formalin Recycler | $0.00 | $0.00 | $0.00 | ||
| AutostainerRSt | Stainer | $0.00 | $0.00 | $0.00 | ||
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Authorized Signature: ______________________________________ Phone No: ______________________
To assure these special prices, this sheet must be sent or faxed with company Purchase Order. Prices are F.O.B. Cincinnati, Ohio. Where applicable, sales tax must be added. A $50.00 minimum order is required.