E-Z Spread n' Lift
Order Form - E-Z Lift Products
To order by phone (215) 322-2099 or fax this form (215) 322-1066
by mail...
E-Z Spread N' Lift Industries
1815 Buck Road, Feasterville, PA 19053 U.S.A.



Sold To : PO # Ship To : (if different)
Co Name (if applicable) :

Co Name (if applicable) :

Name :

Name :

Address :

Address :

City :

City :

State/Zip Code :

State/Zip Code :

Daytime Phone :

Daytime Phone :

Fax :

Fax :

E-mail :

E-mail :

 
Qty.
Description
Price (ea.)
Total
   E-Z TV Lift 1,495.00  

   E-Z Lift 12" Model 895.00  

   E-Z Lift 22" Model 1,095.00  

   E-Z Tool 950.00  

   Extension Tube Assembly 95.00  

   E-Z Tool Carrying Bag 45.00  

 

Add $55 for shipping to the price of the E-Z Lift, E-Z TV Lift, and E-Z Tool. Add $25 for shipping to the price of the extension tubes and carrying bag.
PAID BY : (Check One) Credit Card Info (if applicable)    
[   ]  Check Name on Card : Total Amount

$
[   ]  Money Order Card # : CVV2 #:

 
[   ]  Master Card Expiration Date : PA Add 6% Tax

$
[   ]  Visa Card Signature GRAND TOTAL

$

Prices are subject to change without notice.