Falcon CLAS90EIRB-CH, CLAS110EIWH-BR Special Order Form - Please Call To Order

SPECIAL ORDER FORM

INVOICE TO:

DATE:

ORDER NO:

SPECIAL ORDER REQUEST FOR SHIPMENT

PLEASE ADD THE FOLLOWING MODEL(S) TO THE NEXT AVAILABLE CONTAINER

Model No

Eg: TOLS110DFRB

Colour

Eg: Royal Blue

Trim

Eg: Brass or
Chrome knobs &
handles

Fuel Option

Eg: Dual Fuel,
Electric or Gas

NG or LPG

If applicable specify
natural gas or LPG

Quantity

Eg: 1 only

DELIVERY LOCATION:

SPECIAL ORDERS:

Our intentions are for the good(s) to be available in approximately 14 weeks from date
Special Order Form received by Andi-Co Australia Pty. Ltd. Orders will only be accepted
upon receiving Special Order Form signed by customer and/or retailer. By signing the Special
Order Form the customer is accepting the following terms and conditions:

 Cancellation of orders will not be accepted under any circumstances

 Andi-Co will notify customer when goods arrive upon which full payment must be received
 Customer must accept delivery within 1 week of Andi-Co receiving ordered goods, even if

received prior to the anticipated 14 week availability date

 14 weeks is an approximate time frame only – goods may arrive earlier or later than anticipated

due to circumstances out of Andi-Co’s control

CUSTOMER:

Print:

STAFF MEMBER

Print:

Sign:

Sign:

DATE:

DATE:

PLEASE READ CAREFULLY BEFORE YOU SIGN

PLEASE SIGN & FAX BACK TO FALCON: [phone]