The Fordson House
A Division of the U.P. Outdoor Power Center

717 Stephenson Avenue
Escanaba, MI-49829
Phone: 906-786-5120
Fax: 906-789-5540

Name

Address

City

State

Zip Code

Telephone

Date of Order

 

Tractor Model & Make:

Year:                 Tractor Serial #:

Engine:               Engine #:

Special Information:
Quantity
Ordered
Part
Number
Description of Item
Price
per Item
Total Price
         
         
         
         
         
         
         
         
         
         
         
         
         
         

Please indicate your
Method of Payment:

Check or money order:
Visa:
MasterCard:
Card #:

Exp Date:

Signature:

$10 minimum credit order

SHIPPING ESTIMATE

Up to $10.00 - $6.25
$10.01 to $15.00 - $6.75
$15.01 to $20.00 - $7.00
$20.01 to $30.00 - $7.25
$30.01 to $50.00 - $7.75
$50.01 to $75.00 - $8.25
$75.01 and over add 10%

Above postage for mailable items only - does not apply to heavy castings

Sub Total  
Balance Due Us  
Credit  
- -
SALES TAX
(MI residents only)		  
Insurance
(by request only) 		 
Shipping  
TOTAL ENCLOSED