RAYPLEX LTD.

341 DURHAM CRT., OSHAWA ONTARIO, CANADA L1J 1W8

TEL: (905) 579-1433 FAX: (905) 579-1431

FAX ORDER

NAME: _______________ _____________________ DATE: _________________

COMPANY_________________________________________

ADDRESS: _______________________________________

CITY ____________________ PROV.________ P/C __ __ __ - __ __ __

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E-MAIL _____________________________________________

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Qty.	Stock #	Description	Price








		Web Order Discount 10% Conditions Apply

Taxes and Shipping Charges extra
Payment Cash Cheque Credit Card
Cardholder will Pay Card Issuer above amount Persuant to Cardholder Agreement.
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EXPIRY DATE: ___/____ SIGNATURE ___________________________
Phone with order total for Credit Card Number___ Advise any related Specials___
SHIPPING: UPS / Pick-Up / Cheapest Way

FAX THIS ORDER TO 905 579-1431