Northland Fasteners

Name

 

Phone Number

Address

 

City

 

State

Zip Code

E-mail

 

Attention:

PRODUCT INFORMATION

Item No

Description

Qty

Price

(Qty X Price)

Total Price

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Sub Total      

 

Missouri Residents Only

(Sub Total x 0.07485 )

Sales Tax

 

$10.00 For First Two (2) Items + $3.25 Each For Three (3)Additional ItemsWith in the Continental United States  Call on a large orders for shipping cost

Shipping

 

Add (Sub Total + Sales Tax +Shipping )

Total

 

For Special Shipping

Call us at

816-453-7277

 

Fax this form to
816-453-7277

Or Mail Form To:
Northland Fasteners
615 Northeast 45th Terrace
Kansas City, MO 64116