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