Captain Mike's Marine, LLC
830 Silver Point Road Chapin, SC 29036-7963
855-485-1986 toll free
803-345-1986 shop
803-608-1384 cell
www.captainmikes.org
Name: ___________________________________________ Date: ________________
Shipping Address:________________________________________________________
City: ______________________________ State: _____________ Zip: _____________
Phone: ______________ E-Mail: ___________________________________________
Vehicle / Injector Information
Year and make of Vehicle / Engine: ___________________________ Model:_______________________
Type of Engine: Outboard ___ Motorcycle ___ ATV ___ Car ___ Truck ___ Other _________________
Total Number Of Injectors Shipped ____________ ($20.00 each) + Return Shipping & Insurance
Return Shipping (we currently use UPS)
Please select how you would like your injectors returned shipped. UPS Ground ____ UPS Next Day ___
Your package is insured for $100.00 only. Additional Insurance is 1.00 per $100.00.
Extra Insurance: _____________________ ($100, $200, $300, $400, $500 etc.)
If you choose not to carry extra Insurance for the Return Shipment,
Captain Mike’s Marine will not cover the cost of replacing your injectors due to lost shipments.
We strongly recommend that you buy enough insurance for you to replace your injectors !
Payment
Captain Mike’s Marine uses PayPal " Pay By Invoice "
You Do Not have to have a PayPal account!
When we receive your injectors, we will send you an E-mail / Invoice through PayPal.
The Invoice will show cleaning cost + shipping. Click on the link on the E-mail / Invoice to pay.
You can use any credit card or a PayPal account to pay the invoice.
PayPal will send us back an e-mail stating that you have paid the bill.
We will send back your injectors at that time.
This is the safest way for you and us. PayPal site is secure, safe and easy!
We do not see any credit card information which protects You!
You must supply your e-mail address to get billed.
We do not share any information with others!
Thank You for your Business!