User guide

INTRODUCTION
6
SPARE PARTS ORDER
Fluid Management Parts Order Form
Photocopy and use this form to
Mail or fax orders to:
IDEX
Phone: 1(800) 462-2466
1023 Wheeling Road | Fax: 1(847) 537-5530
Wheeling, IL 60090 |
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Sold To:
Ship To:
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Purchase Order Number_________________
Ship Via: ______________________
Collect Prepaid
Taxable Tax Exempt (Fax copy of exemption certificate.)
QUANTITY PART
NUMBER
DESCRIPTION UNIT
PRICE
S
S
S
S
S
S
S
S
S
S
S
Comments: ____________________________________________________
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Signature
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Date: