ORDER FORM     

1421 Banks Road

Margate, Florida 33063

Ph: 954.917.5296

Fax: 954.973.2550

Insync Business Solutions
Purchase Order #:_______________________          Date:_____/_____/_____

Company Bill To Information:

         Company Ship To Information:

               Name:____________________________

         ____________________________

           Address:____________________________

         ____________________________

                 City:____________________________

         ____________________________

  Phone & Fax:____________________________

         ____________________________

Order Information
Requested By

Ship Via

Location

Required Date Customer #

Terms

           
Product Codes  : 1001- Black,   1002- White,  1003-Gold

Total Units

     UnitPrice$$           

Ext.(Total)          Price$

Item/Style Color Small Med. Large X-Lrg. XX-Lrg. XXX-Lrg.
                     
                     
                     
                     
                     
                     
                     
                     
                     
                     
                     
                     
TOTAL                  
SHIPPING CHARGES ARE TO BE DETERMINED BY VOLUME OF ORDER.

Thank You For Your Business

Note:                                                                                                                                                                                                    
Returns will not be accepted without prior permission from IBS. All claims must be made within 5 days after receipt of goods.   Customer accepts and agrees to terms and conditions incorporated in the contractual agreement. Terms start from the date of shipment.
Signed:______________________ Title:_____________________  Date:_____________
THIS ORDER FORM MUST BE SIGNED BY A MANAGER/or SUPERVISOR OF THE DEPARTMENT OF THE COMPANY