Order Form
CHRIS'S CABLESTM Hand Made Precious Metal Cables
Order Form phone ‑ 225‑929‑6964 // e‑mail ‑ chriscables@cox.net
Date ________/________/___________
Name__________________________________________________
Address________________________________________________
City ___________________________________________________
State ___________________ Zip __________________________
Payment Method :
Check Number: _________(enclosed) Amount: _____________
Credit Card Number: Visa or Master Card
_____________________________________________________
Expiration Date : ____/____/________
3-digit Security Code: _______________
Name on card: ____________________
C.C Billing Address _________________
_____________________________
Authorization Signature : _______________________________ required for credit cards.
Phone _____-_____-________
email ______________________
Re-Sale (Wholesale only) #_____________________
Cable O D Length Quantity Metal Clasp Unit Price Amount Due
MM inches J / B
(Circle one)
Special order
Size
Quantity
Metal
Unit Price
Amount Due
Sub-Total $_______.____
For US Mail 2-Day Priority Delivery, Insured with Return Receipt 2/1/2018
$50 to $100 Add …$13.75 $301 to $400 Add….$16.65
$101 to $200 Add.…$14.45 $401 to $500 Add….$17.80
$201 to $300 Add $15.50 $501 to $600 Add….$23.70
**Larger orders will be billed based on insurance value and according to USPS rates plus $2.00 handling.
For Priority Mail Express - US Mail Delivery : $50 to $100 Add…. $31.65
For Next Day Insurance amounts - $100-$500 – add -$38.25
Shipping, Insurance and Handling $_______.____
Send this order form to: Total Due $_______.____
Christopher A. Hentz Notes:
PO Box 80604,
Baton Rouge, LA. 70898
e-mail – chriscables@cox.net
Order Form phone ‑ 225‑929‑6964 // e‑mail ‑ chriscables@cox.net
Date ________/________/___________
Name__________________________________________________
Address________________________________________________
City ___________________________________________________
State ___________________ Zip __________________________
Payment Method :
Check Number: _________(enclosed) Amount: _____________
Credit Card Number: Visa or Master Card
_____________________________________________________
Expiration Date : ____/____/________
3-digit Security Code: _______________
Name on card: ____________________
C.C Billing Address _________________
_____________________________
Authorization Signature : _______________________________ required for credit cards.
Phone _____-_____-________
email ______________________
Re-Sale (Wholesale only) #_____________________
Cable O D Length Quantity Metal Clasp Unit Price Amount Due
MM inches J / B
(Circle one)
Special order
Size
Quantity
Metal
Unit Price
Amount Due
Sub-Total $_______.____
For US Mail 2-Day Priority Delivery, Insured with Return Receipt 2/1/2018
$50 to $100 Add …$13.75 $301 to $400 Add….$16.65
$101 to $200 Add.…$14.45 $401 to $500 Add….$17.80
$201 to $300 Add $15.50 $501 to $600 Add….$23.70
**Larger orders will be billed based on insurance value and according to USPS rates plus $2.00 handling.
For Priority Mail Express - US Mail Delivery : $50 to $100 Add…. $31.65
For Next Day Insurance amounts - $100-$500 – add -$38.25
Shipping, Insurance and Handling $_______.____
Send this order form to: Total Due $_______.____
Christopher A. Hentz Notes:
PO Box 80604,
Baton Rouge, LA. 70898
e-mail – chriscables@cox.net