Andean Wares - 7801 NW 37 Street,
suite 979781, Miami, FL 33166 USA - Fax 305-468-6162
Print this form and use it for reference when placing your order by mail or FAX
it to us.
| (A)
Ship To: (name and address) Fed Ex and UPS can not ship to Post Office Boxes or apo addresses |
(B) Bill To:
(please fill in bill to information if this differs from your shipping address) |
| Name: _____________________________ | Name: ________________________________ |
| Address: ___________________________ | Address: _______________________________ |
| Address: ___________________________ | Address: _______________________________ |
| City: ____________ State: __________ Province:______ Zip: _______ Country: ______ |
City: ___________ State: _________ Province:________ Zip: ________ Country: ________ |
| Telephone: ______________________ | Daytime Telephone: ______________ |
| Email (if any): ____________________ | Email (if any): ____________________ |
| Above information must match your issuing banks records when using a credit card. |
(C) List of Items:
| Item #: | Item Name: | Quantity: | Size (if applicable) | Price per Item: | Total: |
| Subtotal $ |
(D) Totals & Shipping:
| Carrier | Delivery Time | Order Amount | Continental USA | Puerto Rico, Hawaii and Canada | International Orders |
| First Class Mail (tracking through http://www.usps.com/) | 8 - 15 Business days | 0 to $149.99 | $6.95 | $8.95 | Not available |
| $150.00 to $499.99 | FREE | $12.95 | Not available | ||
| $500 and up | FREE | $17.95 | Not available | ||
|
USPS Priority Mail (tracking through http://www.usps.com/) |
5-7 Business days |
0 to $149.99 | $8.95 | $13.95 | $18.95 |
| $150.00 to $499.99 | $12.95 | $15.95 | $20.95 | ||
| $500.00 and up | $17.95 | $17.95 | $25.95 | ||
|
2nd Day Air (tracking through http://www.ups.com/) |
3-5 Business days |
0 to $149.99 | $18.95 | $20.95 | Not available |
| $150.00 to $499.99 | $20.95 | $22.95 | Not available | ||
| $500 and up | $22.95 | $25.95 | Not available | ||
|
Next Day Air (tracking through http://www.fedex.com/ or http://www.ups.com/) |
2-3 Business Days | 0 to $149.99 | $23.75 | $26.75 | $32.75 |
| $150.00 to $499.99 | $26.75 | $28.75 | $36.75 | ||
| $500.00 and up | $28.75 | $30.75 | $38.95 |
|
|
|
| Merchandise Total: $ | |
| (Our minimum order is 25.00, not including the cost of shipping.) | |
| Shipping (choose one) | |
| Certified First Class Mail: __________ | |
| USPS Priority Mail: _________ | |
| Second Day Deliveryl: __________ | |
| Next Day Delivery: _________ | |
| TOTAL: $ |
(E) Method
of Payment:
___ Money Order (payable to "MP Commercial Ltd")
___ American Express _____ Mastercard ____ Visa ____Discover ____ Diners
______ Carte Blanche ____ JCB
Credit card # _______________________________ & exp.
date:
800 # on back of credit card__________________________ CVV:
_______
I agree to pay the above total amount according to card issuer agreement X_________________________Date_______