
Quantity of 2 1/4” Badges Ordered:
_____ Badges @ $.85 each =$______________ (1 to 24)
_____ Badges @ $.80 each =$______________ (25 to 99)
_____ Badges @ $.78 each =$______________ (100 to 249)
_____ Badges @ $.75 each =$______________ (249 +)
USPS Priority Mail Shipping, Handling and Insurance:
Total: ______ COD ______ 30 days $ __________ + $ _______(S&H&I) = $
___________
Sold to: Ship to: _____same
Name: ____________________________ Name: ______________________________
Address: ___________________________ Address: ____________________________
City:
Zip: ___________ Phone: _______________ Zip: __________ Phone: _______________
Signature: ___________________________ Title: __________________
Date: __________
Orders may be Faxed or sent by electronic mail or by US
Mail.
Delinquency Charge is 1 ½% per month on all past due
balances. Returned Check Fee is $30.
Send Payment to:
Roadhouse
www.roadhouse66.com dave@roadhouse66.com Phone: 614-989-4515 Fax: 614-890-3863