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Welcome To SUPER SAFETY!            PRINTABLE VERSION
WWW.SUPERSAFETY.COM

 CLICK HERE TO GET PDF ORDER FORM PDF LOADER AT Get Adobe Reader

Super Safety Order Form

Tell us what you want to order phone it in at (800) 275-8239 This page is under construction for E-commerce email WEBMASTER

International Number USA (773) 538-3333  FAX this to (773) 538-8080

Company Name:__________________________________________Order what you want with this form contact us by phone (800) 275-8239

 

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:__________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

  Part Number Item Name Description if Applicable Quantity Cost
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Some items may have minimums.

Payment: Credit Card, Company Check (must be cleared or guaranteed with PO), 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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