(Enter item number and description, select quantity desired and enter price.)

Item No. Description Quantity Price
SUB-TOTAL:
Pennsylvania Resident? NO    YES    TAXES:
SUB-TOTAL:

Now print-out & hand write the balance of your order form & mail with payment enclosed!
SHIPPING (see rate chart below)   
$ .
RUSH ORDERS (shipped within 48 hrs)
Send U.S. POSTAL MONEY ORDER ONLY & add $5.00 
$ .
GRAND TOTAL 
$ .

Shipping Rates   (USD$ Continental USA 48 States)
Under $20 add 7.25 $20.01-$40 add 8.95 $40.01-$60 add 10.95
$60.01-$85 add 12.95 $85.01-$125 add 13.95 $125.01-$150 add 15.00
$150.01-$200 add 15.95 $200.01-$250 add 16.50 $250.01 and over add 18.00
*Drop-shipping: Email your order for rate quote to your locations zip code.
Canada, Alaska, Hawaii, APO, FPO, double above rates. Others and foreign, require INSURED AIRMAIL (Air Letter Post). Email your order for rate quote to your location.

Pennsylvania residents must add 7% sales tax.
Concerns or considerations? Email: info@protectivespecialties.com

DISCLAIMER: Due to our inability to supervise your installation and/or use of the products offered herein, the owners, heirs and assigns of Protective Specialties Development Group, disclaim any liability due to accident or injury to any degree due to the use or misuse of any of the products or information which may be part of this order. By placing this order you verify that you are at least 18 years of age, and agree not to bring suit and to be bound by the conditions of this statement.

Customer's Signature:
____________________________________________________

(Ship to) Name: ____________________________________ Date: _____________

Address: _____________________________________________________________

City: ____________________________ State: ________ Zip: _________________

Phone: ___________________ Fax: _________________ Email: _______________
(Email address required so we may acknowledge your order).

Send check or money order via US Mail with total payment to:
*Protective Specialties Development Group*
PO Box 39060 (WP)
Philadelphia, PA 19136

We supply industry proven, quality products at fair prices. You're Gonna Love 'Em!