orders

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P u r c h a s e   O r d e r

Name

 Address







City                         State                         Zip

 PAYMENT METHOD Certified check #                      Money order#

 ITEM NO. DESCRIPTION     UNIT QTY UNIT COST TOTAL AMOUNT

Ohio residents add 6% sales Total w/o shiping$ Total with shiping $

Call or email us for shipping prices on your order before mailing. Oh res. with tax total $