AUTHORIZED APPLIANCE PARTS
866 Langs Dr., Cambridge, Ontario N3H 2N7
BY MAIL: Simply fill out this form and mail to address above. Please include day and evening phone numbers
2/01
TO ORDER BY PHONE, PLEASE CALL:
S
O
L
D
T
O
NAME
ADDRESS (street address needed)
CITY | STATE | ZIP |
S
H
I
P
T
O
NAME
ADDRESS (street address needed)
CITY | STATE | ZIP |
DAYTIME PHONE | EVENING PHONE |
DAYTIME PHONE | EVENING PHONE |
FAX |
FAX |
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 (CAD) |
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| Total |
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ACCESSORIES/TOOLS: |
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| EXTENSION WANDS |
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| 4.49 |
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| DUSTING BRUSH |
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| 3.89 |
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| CREVICE TOOL |
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| 2.99 |
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| STRETCH HOSE |
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| 11.99 |
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| DISPOSABLE PAPER BAGS, BELTS AND DELUXE ALLERGEN FILTERS MUST BE | PURCHASED AT YOUR | LOCAL WAL- | MART STORE OR |
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| www.walmart.com. |
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MISCELLANEOUS PARTS: |
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| HEADLIGHT - package of 2 |
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| 2.39 |
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| BRUSH ROLL |
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| 23.84 |
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| MOTOR FILTER |
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| 1.49 |
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| FRONT WHEEL - package of 2 |
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| 2.54 |
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| REAR WHEEL - package of 2 |
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| 2.99 |
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| UPPER CORD HOOK |
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| 1.49 |
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| HOSE RETAINER |
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| 1.49 |
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| FRONT COVER LATCH |
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| 1.49 |
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| REAR AIR TUBE |
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| 7.49 |
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| REAR AIR TUBE FASTENER - package of 2 |
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| 1.94 |
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| ALLERGEN FILTER FRAME |
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| 2.99 |
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| FILTER COVER |
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| 4.49 |
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Method of Payment: |
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| TOTAL (prices subject to change without notice) |
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| Check or Money Order (payable to Authorized Appliance Parts) |
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| TAX (add G.S.T. & P.S.T. as required by law) |
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| MasterCard |
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| POSTAGE & HANDLING CHARGE |
| $8.25 |
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| TOTAL (please no cash or C.O.D.s) |
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| Exp. Date: |
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| Month |
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| Printed in U.S.A. | ||||||
Signature (full name as shown on acct.) _____________________________________________ |
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| 71550 | |||||||||||||||||||||||||||||
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