Exotic Segmented Vessel

Jim Rodgers'

ORDER FORM
Make checks payable to:
Jim Rodgers
236 Briar Drive
Martinez CA 94553

PH. 925-229-5773
Email: jlrodgers236@comcast.net		 Date: 
Bill To
Ship To (fill in only if different)
Name:  Name: 
Address:  Address: 
City:  City: 
State/Zip:  State/Zip: 
Phone:  Phone: 
E-mail:  E-mail: 
Product Code Quantity Description Shipping Amount
Total Shipping: 
Sub Total: 
CA residence only Tax 9.25%: 
Total: 
Comments:

You are welcome to call Jim and he can take your order over the phone in just a few minutes. We accept PayPal, money orders or Cashier's checks. For personal checks we will ship after the check clears the bank.

Shipping charges may vary from product to product. I will confirm your shipping charges and tax (if any) in an e-mail.

Business hours Pacific Time: 8 am - 5 pm

http://jlrodgers.com