ORDER FORM
Company Name:
Contact Name:
Company's Address:
Phone:
Email:
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]
Early Bird Ordering by April 7th, 2017. Orders placed after April 7th, will have a
$50.00 late fee .
DEADLINE FOR ORDERS IS APRIL 14th, 2017
WATER DRINKS (24 bottles per case)
PCODE
103513
ITEM DESCRPTION
16.9oz Aquafina Bottle
FRUITSHOOT KIDS DRINKS (24 bottles per case)
PRICE
QTY
$ 7.00
00
GATORADE / ENERGY DRINKS (24 bottles per case)
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
PCODE
ITEM DESCRPTION
PRICE
QTY
103013
10oz Fruitshoot Strawberry
$ 15.00
00
103022
10oz Fruitshoot Berry Burst
$ 15.00
00
SOFT DRINKS (24 cans per case)
QTY
PCODE
ITEM DESCRPTION
PRICE
QTY
00
00
100705
Pepsi Can
$ 11.43
00
100706
Diet Pepsi Can
$ 11.43
00
00
00
100710
Mountain Dew Can
$ 11.43
00
100711
Diet Mountain Dew Can
$ 11.43
00
100781
Grapico Can
$ 11.43
00
100762
Dr. Pepper Can
$ 11.43
00
100798
Sunfresh Lemonade
$ 11.43
00
BARREL BIN RENTAL
ITEM DESCRPTION
PRICE
Cooler for drinks
Bags of Ice (we recommend 4 bags of ice per barrel) $ 4.00 per bags of ice
QTY
$ 25.00
0
$ 4.00
0
Please Note: A non-refundable $100 fee will added to bill if the barrel is not returned to Buffalo
Rock employees or left at the premises.
ORDER SUBTOTAL
TAX
ORDER TOTAL
0.00 -
$
$
0.00
$
0.00 -
Early Bird Ordering by April 7th, 2017. Orders placed after April 7th, will have a $50.00 late fee .
DEADLINE FOR ORDERS IS APRIL 14th, 2017
-