REPLACEMENT PARTS ORDER FORM
Total Parts | $ |
Sales Tax | $ |
Shipping & Handling | $ |
Outside Continental USA | $ |
Total | $ |
We must have this information to process your order: see label on bottom tubing of Playard.
Model No.:
Manufacture Date:
Please make checks payable to CENTURY PRODUCTS or charge to VISA, MASTERCARD or DISCOVER.
Orders outside USA Must use credit card.
Cardholder’s Name:
Card Number:
Card Exp. Date:
Check enclosed for $
Sales Tax
•California, Illinois, Indiana, Maryland and New York Residents Add Sales & Applicable Local Taxes
•Ohio Residents Add 5.75% Sales Tax
•Pennsylvania Residents Add 6% Sales Tax except for Philadelphia and Allegheny Counties add 7% Sales Tax
•South Carolina Residents Add 5% Sales Tax
Shipping & Handling |
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| US $ | 0.01 to $ | 9.99 | = | US $ 3.00 |
(CAN $ | 0.01 to $ | 15.49 | = | CAN $ 4.75) | |
| US $ 10.00 and over | = | US $ 5.00 | ||
(CAN $ 15.50 and over | = | CAN $ 7.75) | |||
Outside Continental USA |
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Add: | US $ 10.00 |
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| (CAN $ 15.50) |
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NOTE: If requested color is not available, a similar color will be substituted.
SHIP TO:
Name:
Address:
City:
State:Zip:
Telephone No.:( | ) | |
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MAIL BOTH PAGES OF ORDER TO:
CENTURY PRODUCTS
P.O. BOX 100
ELVERSON, PA
ATTENTION: CUSTOMER SERVICE DEPARTMENT
FAX BOTH PAGES OF ORDER TO:
(610) |
