| Print out this form on you printer (Do a Page Set-up) |
| GRAND SCALE SIGNAL COMPANY 974 Morena Ct., Ballwin, MO 63011 Bus Phone: (314) 774-4772 email: rsb7284@hotmail.com |
| Purchasers Address: Name: _________________________________________ Address 1: _________________________________________ Address 2: _________________________________________ City/St/Zip: _________________________________________ Phone: ( ) - |
Totals: If order is shipped within the State of Missouri - Add Sales Tax @ 8.125%: Shipping & Handling (see rate chart below): TOTAL DUE with ORDER: By check, cashier's, MO - Sorry no ATM or Credit Cards Shipping & Handling rates - USA ONLY (to find mileage - access an internet map service - From St. Louis, MO to your town) up to 250 Miles 251 to 500 Miles 501 to 1000 Miles 1001 or more Up to 25 lbs. $ 15.00 $ 15.00 $ 17.00 $ 20.00 26 to 100 lbs. $ 30.00 $ 35.00 $ 45.00 $ 60.00 101 to 500 lbs. $ 45.00 $ 55.00 $ 70.00 $ 100.00 501 to 1000 lbs. $ 75.00 $ 100.00 $ 150.00 $ 250.00 PLEASE NOTE: Shipping rates my change without any notice - we will contact you should those rate be greatly different - we ship by FedEx (also USPS, UPS, DHL, your preference) - Large items such as Signal Bridges are shipped by Truck, Call for Rate. |
__________________Discription of Item_____________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ |
Quanity_ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ |
__Cost Each___ ______________ ______________ ______________ ______________ ______________ ______________ ______________ ______________ ______________ ______________ ______________ ______________ |
____TOTAL___ ______________ ______________ ______________ ______________ ______________ ______________ ______________ ______________ ______________ ______________ ______________ ______________ ______________ ______________ ______________ ______________ |
__Wt.__ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ |
| Ship To: Name: __________________________________________ Address 1: __________________________________________ Address 2: __________________________________________ City/St/Zip: __________________________________________ Phone: ( ) - |
Order or ____Part #_____ ______________ ______________ ______________ ______________ ______________ ______________ ______________ ______________ ______________ ______________ ______________ ______________ |
Order Date: _________________________________________ 20 _______ Call or email (rsb7284@hotmail.com) or snail mail to us this order form and we will fill in the shipping weights, Sales Tax (if any) and the Shipping & Handling Charges. We will then send this order form back to you via email or even snail email. |
| Railroad Coupler Receiver Cover (Wt. 5 lbs. each) |
| $30.00 |
| SPECIAL |