Order Form
Company Name:
Contact Name:
Phone:
Company's Address:
Email:
Alabama Sales Tax Liscence Number (if applicable) :
Credit Card
Payment Method (please choose one) :
Type:
q Yes q No
q Yes q No
Check
qVisa qMastercard
qDiscover qAmex
Check number:
Credit Card #
Credit Card Expiration Date
Credit Card Holder's Name:
Credit Card Security Code
Please fill out the form with the quantity of desired drinks. For more information please contact
Cristina Almanza at 205.944.4087 or via email at [email protected]
WATER DRINKS (24 bottles per case)
PCODE
103501
ITEM DESCRPTION
20oz Aquafina Bottle
GATORADE / ENERGY DRINKS (24 bottles per case)
PRICE
QTY
$ 16.40
SOFT DRINKS (24, 20oz. bottles per case)
PCODE
ITEM DESCRPTION
PRICE
QTY
PCODE
ITEM DESCRPTION
103055
20z Gatorade Glacier Freeze
$ 22.60
103059
20z Gatorade Fruit Punch
$ 22.60
103061
20z Gatorade Lemon Lime
$ 22.60
103099
20z G2 Grape
$ 22.60
PRICE
100301
20oz Pepsi Bottle
$ 20.00
100302
20oz Diet Pepsi Bottle
$ 20.00
Total Number of Cases
100303
20oz Mountain Dew Bottle
$ 20.00
100304
20oz Diet Mountain Dew Bottle
$ 20.00
0
100362
20oz Dr. Pepper
$ 20.00
Total Number of Drinks
100363
20oz Diet Dr. Pepper
$ 20.00
0
100398
Sunfesh Lemonade
$ 20.00
100400
Mist Twist
$ 20.00
Orders Will Be Available for Pickup Onsite:
On Friday, September 30, 2016
From 1 P.M. - 5 P.M.
ORDER SUBTOTAL
TAX
On Saturday, October 1, 2016
LATE FEE
From 6 A.M. - 9 A.M.
ORDER TOTAL
0.00
$ 0.00
-
0.00
-
$
$
Early Bird Ordering by SEPTEMBER 16 th , 2016. Orders placed after September, 16th will have a $50.00 late fee .
DEADLINE FOR ORDERS IS SEPTEMBER 23rd, 2016
~Please note No Orders will be fufilled after that~
QTY
-