BILL TO: SHIP TO: (If Different)
Name______________________________________ Name______________________________________
Company Name Company Name
(If Applicable)___________________________ (If Applicable)___________________________
Address___________________________________ Address___________________________________
City,State,Zip____________________________ City,State,Zip____________________________
Tel_________________ Fax__________________ Tel_________________ Fax__________________
E-Mail (For Confirmation)_____________________________________________________________
Item # Description Quantity Ship Wt Cost Each Total Amount
_________ _____________________________ ________ _______ _________ ____________
_________ _____________________________ ________ _______ _________ ____________
_________ _____________________________ ________ _______ _________ ____________
_________ _____________________________ ________ _______ _________ ____________
_________ _____________________________ ________ _______ _________ ____________
===============================================
Sub Total ____________
Add US$3.00 Handling
for US shipments and
US$15.00 for shipments
outside of the US. ____________
Add Applicable
Sales Tax (GA Only) ____________
Shipping Charges
If using C.O.D, Wire
Transfer, or
Cashier/Company Check,
call for amount.
Amount will be added
by CPS for Credit
Card orders ____________
COD - Add US$7.50 ____________
===============================================
Total ____________
METHOD OF SHIPMENT:
__ UPS Ground
__ 3 Day Service
__ 2 Day Air Service
__ Next Day Air Service (PM Delivery)
__ Next Day Air Service (AM Delivery)
__ International Shipments (Please call for freight quote)
METHOD OF PAYMENT:
__ Visa __ MasterCard __ American Express
Account Number________________________________ Exp. Date__________________
Security Code _________ (For American Express - 4 digits on the front
For Visa/MasterCard - 3 digits on the back)
Cardholder Printed Name___________________________________________________
Signature_________________________________________________________________
__ C.O.D. (Money Order/Cashiers Check Only, Call for Transaction Total)
__ Wire Transfer (Call for account information)
__ Check - Prepay (Please make Money Order/Cashiers Checks payable to: Computer
Peripheral Solutions, LLC, Call for Transaction Total)
Note: Prepayment and C.O.D. not available for export shipment.
__ Net 30 Days (Account must be previously established. Authorized P.O. # required)
Purchase Order Number: _____________________________________________
30 Day Guarantee:
If you are not completely satisfied, we will gladly replace the merchandise
or, if you prefer, refund your purchase price of the unit within 30 days.
Exchange Returns:
If you need to exchange or return products within 30 days, please include
all original packaging and paperwork you received with your order and contact us at
770-638-7640 to receive a Return Authorization number (RMA).
NOTE: Software, Custom products and Special orders are not exchangable, returnable
or refundable.
Return merchandise to:
Computer Peripheral Solutions, LLC
5295 Webb Parkway NW
Lilburn, GA 30047
Computer Peripheral Solutions, LLC
5295 Webb Parkway NW
Lilburn, GA 30047
Sales
1-800-888-0051
9:00 AM - 5:30 PM EST
Technical Support
(770) 638-7640
9:00 AM - 5:30 PM EST
Fax
(770) 638-8659
E-Mail
sales@cpscom.com