THM Management Company
Faxable Quote / Order Form
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FAX IT BACK-
PASCO: 1-509-547-6478
CONNELL: 1-509-234-3214
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Date:
__________
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Account No. :
Purchase Order No. :
Customer Name:
__________________________________
Address:
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City:
State:
Zip Code:
_____________________
________________________________
Shipping Address:
Contact Name:
________________________________
Special Instructions:
E-mail
Address:
_______________________
________________
Quote:(X)________
Order:(X)________
Date Needed By:
Qty.
Each Price
Your Part No.
Line Total
NAPA Part No.
Description
Sub Total:
_______________________________
THM Representative / Contact:
Tax:
E-mail Address & Phone Number:
_____________________________
Estimated Freight:
Need Help? Call 1-800-887-0770 or E-mail us at www.thmmanagementco.com
Total:
FAX IT BACK TO US - 1-509-547-6478
Any other comments or instructions can be listed below -
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