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FACTORY DIRECT QUOTATION / ORDER
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Please print this page, fill it in and fax to: 61 3 9782 5227
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Customer Name: .................................................
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Customer Shipping Address:
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...................................................................................
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...................................................................................
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Order Date: ..............................
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S1000 short bed
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S1000 long bed
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S750 short bed
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S750 long bed
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S500 short bed
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S500 long bed
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NUGGET
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Prices DO NOT include GST
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I have read and agree to the above Terms & Conditions.
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Customer Signature ....................................................................
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