AUTHORIZED APPLIANCE PARTS
P.O. BOX 2799, BLOOMINGTON, IL 61702-2799
BY MAIL: Simply fill out this form and mail to address above. Please include day and evening phone numbers
8/01
TO ORDER BY PHONE, PLEASE CALL:
S
O
L
D
T
O
NAME
ADDRESS (street address needed for UPS)
CITY | STATE | ZIP |
DAYTIME PHONE |
| EVENING PHONE |
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FAX |
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H
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P
T
O
NAME
ADDRESS (street address needed for UPS)
CITY | STATE | ZIP |
DAYTIME PHONE |
| EVENING PHONE |
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FAX |
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IMPORTANT: Be sure to include your model, type, and serial number. These numbers may be found on the rating plate.
MODEL NUMBER: ____________________ | TYPE: ____________ | SERIAL NUMBER: ______________________ | |||||
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| Part Number | Qty. | Price (USD) | Total | |
ACCESSORIES/TOOLS: |
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Upholstery Nozzle with Bristles |
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| 61754 |
| 7.99 |
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Upholstery Nozzle with Sponge |
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| 61755 |
| 8.49 |
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Hose Assembly |
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| 61758 |
| 33.99 |
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MISCELLANEOUS PARTS: |
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Brush Roll |
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| 61759 |
| 10.99 |
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Belt |
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| 61760 |
| 1.99 |
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Clean Water Solution Tank |
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| 61761 |
| 17.99 |
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Tank Cap |
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| 61762 |
| 1.49 |
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Recovery Tank |
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| 61763 |
| 29.99 |
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Filter Package (Reservoir & Basket Filters) |
| 61764 |
| 2.49 |
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Carpet/Floor Suction Cover |
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| 61765 |
| 5.49 |
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Rotor Knob |
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| 61766 |
| 1.99 |
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Boot Seal with Plunger |
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| 61756 |
| .99 |
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Rear Wheel Replacement Kit (wheels, axles, clips) |
| 61757 |
| 3.99 |
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Method of Payment: |
| TOTAL (prices subject to change without notice) |
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Check or Money Order (payable to Authorized Appliance Parts) | TAX (add state tax & local taxes as required by law) |
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| POSTAGE & HANDLING CHARGE (within U.S.A.) | $5.50 |
Exp. Date: | _ | TOTAL (please no cash or C.O.D.s) |
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Month | Year |
| Printed in U.S.A. |
Signature (full name as shown on acct.) _____________________________________________ |
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| 71727 | ||
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