www.600359.com
Name:_____________________________________________________
Address:___________________________________________________
City:_________________________ State:__________ Zip:___________
Phone:_______________________
Description
Subtotal:_________________
Flat Rate Shipping:__$5.00__
Balance Due:_____________
All orders will be shipped UPS unless otherwise indicated.
502 North
First Street • Fairbury, Illinois 61739 • (815)
692-4231