Cases
|
Amount |
Description |
Price
Per |
Total |
|
|
|
500 |
Peppermint Pillows |
$92.00 |
|
|
|
|
500 |
White Buttermints |
$92.00 |
|
|
|
|
500 |
Gourmet
Chocolate |
$92.00 |
|
|
|
|
650 |
Chocolate
Mint Creams |
$108.00 |
|
|
|
|
N/A |
Shipping
& Handling |
$8.00/cs. |
|
|
|
|
|
One-time
Plate Charge |
$48.50 |
|
|
|
|
TOTAL
|
$ |
|||
SHIP
TO
|
NAME |
|
|
ADD 1 |
|
|
ADD 2 |
|
|
STATE |
|
|
ZIP CODE |
|
| Need By Date | |||
| Name | |||
| Address 1 | |||
| Address 2 | |||
| City |
State |
Zip Code |
|
|
Charge Card Information |
|||
| Type of Charge | |||
| Card Number | |||
| Expiration Date: Month |
Year |
||
| Signature | |||