Order Form

Please print this form and fax it to +1 510 483-6453

Bill To:

Name:
Company Name:
Street Address:
City/Town:
State/Province:
Zip Code:
Country:
e-mail address:


Ship To:

Name:
Company Name:
Street Address:
City/Town:
State/Province:
Zip Code:
Country:


This form is not self-calculating

Part no.

Item

Price

Quantity

Total

480 Daytime Running Lights Unit $21.95
480HD Daytime Running Lights Unit (Heavy Duty with power reduction) $44.95
481 Power Reducer $11.45
300 Back-up Alarm $15.95
320 Mini Back-up Alarm $19.95
330 Smart Alarm $51.95
400 Headlights Left-On Reminder $5.95
420 Turn Signal Left-On Reminder $18.95
450 Wipers On-Lights Reminder $14.95
900 Electronic Strobe-Hazard Lite $19.95
910 Portable Adapter-Hazard Lite $9.95
50G Power Tap Fuse Clips (glass) $1.09
50P Power Tap Fuse (blade) $1.09
50S Power Tap Battery Bolt $4.49
Subtotal
If CA resident add 7.75% Tax (CA)
If C.O.D. add $4.75 C.O.D.
See table below for shipping Shipping
Total


Handling & Shipping Charges:

Purchase Amount Standard Delivery Express Delivery
up to $10 $ 5.00+ $9.00
$10 to $20 $ 5.50+ $11.75
$20.01 to $40 $ 7.50+ $13.00
$40.01 to $60 $ 10.00+ $15.00
$60.01 to $80 $11.00+ $17.25
$80.01 to $100 $12.00+ $18.25
$100.01 to $250 $17.50+ $23.25
Over $250 10% of orderStandard + $27.50
Over $500Free in continental U.S.Call for rates
C.O.D. add $4.75 to order.