Tell us what you want to order phone it in at (800) 275-8239    Super Safety Order Form

FAX this to (773) 538-8080 This page is under construction for E-commerce.

International Number USA (800) 275-8239

Company Name:__________________________________________

Address:________________________________________________
 

City: _______________________________ State: ________________________

Zip: _______________________________

Telephone & of name of Buyer: _________________________________________ Email _____________

Telephone & and name of Accounts Payable Person: ________________________  Email _____________

Ship to Address Must be same address on credit card unless credit application is on file.

SAME AS ABOVE CHECK HERE      □

Name and Company: _____________________________________________________________

Address:_______________________________________________________________________
 

City: _______________________________ State: ________________________  ZIP: ________________

Specifications:__________________________________________________________________

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Some items may have minimums. Terms and conditions subject to change depending on locations.

Payment: Credit Card, Company Check (must be cleared or guaranteed), or Cash, money order or cashiers check.  You must provide a phone and we only ship to address on credit card without a credit application (allow 10 days to process / international may be longer). Thank you!

Some items may have minimums, restocking charges beyond our control from manufacturer, shipping VAT, tax, our re-stocking fee 25% and any other costs incurred directly by us to accommodate your special needs.  Credit cards only verified credit card addresses will be shipped too.  Please allow two weeks for delivery.  Expedited shipping let us know additional charges will apply for overnight shipment will depend on orders going in before 1:30 in most cases it will ship the next day.  We do not guarantee delivery times or dates (we do the best reasonably to get your  items out fast).   We ship Federal Express worldwide or Roadway Freight.

Signed X: ________________________________ Date:___________

Credit Card Type: _______________________________

Credit Card Address: ________________________________________

City: ____________________ State: _____________  Country: _________________________Zip: ______________

Credit Card Number: _________________________ Expiration date:________ CV2 or Security No ______

Credit Card Number: _________________________ Expiration date:________ CV2 or Security No ______

Credit Card Number: _________________________ Expiration date:________ CV2 or Security No ______

Cardholders Telephone: ________________________________ Email: _____________________

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