Klip Order Form · 2020. 11. 25. · ORDER FORM YOUR INFORMATION ANCHOR BATH CHAIR ANCHOR BATH...
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ORDER FORM YOUR INFORMATION ANCHOR BATH CHAIR ANCHOR BATH CHAIR ACCESSORIES AN1400 Anchor Bath Chair, Sm AN1600 Anchor Bath Chair, Lg BATH CHAIR Fax to 718.878.2283 • Email to [email protected] 68 35th Street, Brooklyn, NY 11232 T: 718.943.6452 F: 718.878.2283 www.circlespecialty.com [email protected] ITEM # QTY DESCRIPTION MSRP ITEM # QTY DESCRIPTION MSRP Company: Ship To: Account Number: Date: Address: Quote PO Number: City: State: Contact: Zip: Phone: Email: Marked For: AN2100 Anchor Rolling Shower Base AN2110 Lateral Support AN2111 Positioning Straps, XL, Pair $645.00 $65.00 $38.00 $640.00 $660.00
Transcript of Klip Order Form · 2020. 11. 25. · ORDER FORM YOUR INFORMATION ANCHOR BATH CHAIR ANCHOR BATH...
ORDER FORM
YOUR INFORMATION
ANCHOR BATH CHAIR
ANCHOR BATH CHAIR ACCESSORIES
AN1400 Anchor Bath Chair, Sm
AN1600 Anchor Bath Chair, Lg
BATHCHAIR
Fax to 718.878.2283 • Email to [email protected]
68 35th Street, Brooklyn, NY 11232 T: 718.943.6452 F: 718.878.2283 www.circlespecialty.com [email protected]
ITEM # QTY DESCRIPTION MSRP
ITEM # QTY DESCRIPTION MSRP
Company: Ship To:
Account Number: Date: Address:
Quote PO Number: City: State:
Contact: Zip: Phone:
Email: Marked For:
AN2100 Anchor Rolling Shower Base
AN2110 Lateral Support
AN2111 Positioning Straps, XL, Pair
$645.00
$65.00
$38.00
$640.00
$660.00
