Manufacturer



701 Ford Road
Rockaway, NJ 07866
P (973) 625-4056 x231
F (973) 625-9489

INVOICE -

CONTACT: DATE:
ADDRESS: DATE RECVD:
  CUST #:
PHONE: INVOICE: 124808
EMAIL: RA #:  
MODEL: PAY TERMS: ON RECEIPT
SERIAL:  


PLEASE CHECK THE APPROPRIATE BOX:
PARTS SUBTOTAL:
 
LABOR:
 
FREIGHT:
 
MATERIAL:
 
SUBTOTAL:
 
SALES TAX:
 
DEPOSIT:
   
* This form must be signed and sent via email
(customerservice@panurgyoem.com) or via Fax: 973-625-9489.


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SIGNATURE     


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TOTAL DUE:
PLEASE NOTE:
  1. If we do not hear back within 30 days, your unit may be deemed abandoned and scrapped.
    Once scrapped, your unit cannot be salvaged. No refunds will be given.
  2. PanurgyOEM offers a standard 90 day Labor Warranty and 30 day Part Warranty on repairs unless otherwise specified.
  3. Shipping Claims for units damaged in shipping must be filed with 10 days.

REMINDER:
Have you signed and returned this form ?          Have you made payment via PayPal ?

THANK YOU