Online Order Form
Customer Information:
Name:
Company Name:
Vendor's Permit No.
Address:
City:
Province/State:
Country:
Postal/Zip Code:
Phone:
Fax:
Email:
Order Items
Item Number
Qty
Cost
Total
BIN-066
$4.50 EA
BIN-067
$4.25 EA
BIN-068
$4.50 EA
BIN-069
$4.50 EA
BIN-070
$3.75 EA
BIN-071
$3.25 EA
BIN-071 A
$3.25 EA
BIN-071 B
$3.25 EA
BIN-072
$3.00 EA
BIN-073
$3.25 EA
BIN-074
$3.00 EA
BIN-075
$3.00 EA
BIN-076
$3.25 EA
BIN-077
$4.00 EA
BIN-078
$3.50 EA
BIN-080
$3.00 EA
BIN-081
$3.00 EA
BIN-082
$3.50 EA
BIN-085 A
$3.00 EA
BIN-085 B
$3.00 EA
BIN-086 A
$3.00 EA
BIN-086 B
$3.00 EA
BIN-087
$3.00 EA
BIN-088
$3.00 EA
BIN-089
$3.50 EA
BIN-091
$3.50 EA
BIN-092
$3.50 EA
CAC-001
$4.00 EA
CAC-002
$4.00 EA
CAC-003
$4.00 EA
CAC-004
$4.00 EA
CAC-005
$4.00 EA
CAC-006
$4.00 EA
CAC-007
$4.00 EA
CAC-008
$3.25 EA
CAC-009
$3.25 EA
GDH-001 A
$1.50 EA
GDH-001 B
$1.50 EA
GDH-001 C
$1.50 EA
Item Number
Qty
Cost
Total
GDH-001 D
$1.50 EA
GDH-001 E
$1.50 EA
GDH-001 F
$1.50 EA
GDH-001 G
$1.50 EA
GDH-001 H
$1.50 EA
GDH-001 I
$1.50 EA
GDH-001 J
$1.50 EA
GDH-002 BLUE
$1.50 EA
GDH-002 BRN
$1.50 EA
GDH-002 PINK
$1.50 EA
GDH-003 BLK
$1.50 EA
GDH-003 BRN
$1.50 EA
GDH-003 D GRN
$1.50 EA
GDH-003 L GRN
$1.50 EA
GDH-003 RED
$1.50 EA
GDH-003 YELLOW
$1.50 EA
GDH-004 BLUE M
$1.00 EA
GDH-004 BLK M
$1.00 EA
GDH-004 PINK
$1.00 EA
GDH-004 BLK
$1.00 EA
GDH-004 DOLPHIN
$1.00 EA
GDH-004 BRN
$1.00 EA
GDH-005 YELLOW
$2.75 EA
GDH-005 BLK
$2.75 EA
GDH-005 RED
$2.75 EA
GDH-005 BRN
$2.75 EA
GDH-006 BLUE
$5.00 EA
GDH-006 PINK
$5.00 EA
GDH-007 RED
$5.25 EA
GDH-007 BLK
$5.25 EA
GDH-007 BLUE
$5.25 EA
GDH-007 BEIGE
$5.25 EA
GDH-008
$5.50 EA
GDH-009
$5.50 EA
GDH-010
$5.00 EA
GDH-011 BRN
$5.00 EA
GDH-011 GRN
$5.00 EA
GDH-011 BLUE
$5.00 EA
GDH-012
$5.00 SET
Sub total
GST (5%)
PST (8%)
Total
