Gleanei)i
Form for quick ordering by fax
Order
Your reference sign:
We areorderingon your termsof businessandat thecurrentlist pricesplusVAT.
Name
Invoicing
address Sender:
If consultation is required (Pleasefill in using capital letters)
MrJMrs
Tel.
No.
Date/ Signature
Swiss
Made
Fax:
of article
Dept.
Dept.
FloorMac
0041
71 955 47 60
Trade:
Qantity
Delivery address Recipient:
Pleasemark with a crossif invoicing address
and delivery address are identical:
Unit price €1 CH Fr.