Purchase Contract

Please complete the form below, and submit. If you have a question or need further assistance, please give us a call at 877-328-8308.

Purchaser Information

First Name

Last Name

Company Name

Phone Number

Purchaser Billing Address

Country

Address

City

State

Zip

Purchaser Shipping Address

Country

Address

City

State

Zip

F.O.B.

Equipment

Attachments

No attachments.

Trade-ins

No trade-ins.

Contract Totals

Attachments

Subtotal

Plus: Freight

F.E.T.

Less: Trade-in Allowance

Net Purchase Price (After Trade-in)

Plus: Sales Tax

Non-Refundable Down Payment

Balance

Terms & Conditions

Acceptance

Agent acknowledges that he/she has read and understands, and agrees on behalf of Purchaser, to the terms and conditions of this Order, including but not limited to the DISCLAIMER AND RELEASE and EXCLUSION OF CONSEQUENTIAL AND OTHER DAMAGES set forth on the reverse side, and that he/she is authorized to execute this Order on behalf of Purchaser.

Purchaser Accepted Signature

Date Signed