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A+ ICE MACHINE & RESTAURANT EQUIPMENT COMPANY

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COD INFORMATION SUBMISSION FORM

COD PURCHASER INFORMATION. This form must be filled out completely. When we receive this information we will respond with specific COD instructions including a "Bottom Line" quote.

Purchaser Name:

   ( Required )
Company: (Optional)
Street Address:   ( Required )
Apt. or Suite:
City: ( Required )
State: ( Required )
Country   ( Required )
Zip: ( Required )
Telephone: ( Required )
Fax: ( Required )
E-Mail:   ( Required )
SHIPPING INFORMATION.

Name:

 ( Required )

Company:

Street Address:

 ( Required )

Apt. or Suite:

  

City: 

( Required )
State:

  ( Required )
Country   ( Required )
Zip ( Required )
Telephone: ( Required )

SPECIAL INSTRUCTIONS; What equipment are you interested in? Be specific please .. (ie; list all equipment by brand name, equipment, model number, number of pieces, when needed ... etc.)