U-Line Echelon 2075DWRR Service And Parts Manual Supplement page 75

Account# ____________________________________
Bill to: ______________________________________
____________________________________________
____________________________________________
Date:________________________________________
Phone#______________________________________
PART# COLOR
SPECIAL INSTRUCTIONS:
All part shipments will be sent ground delivery.
We have air shipment available at an additional cost to you.
Next Day Air 2nd Day Air
If you do not have an open account with us your order will be shipped C.O.D.
COMMENTS: ________________________________________________________________________________
____________________________________________________________________________________________
FAX PARTS ORDER FORM
FAX # 414-354-7905
QTY DESCRIPTION
3 Day Select
Authorized By ________________________________________________
65
Ship to:______________________________________
____________________________________________
____________________________________________
Attention:
P.O. ________________________________________
Fax# ________________________________________
MODEL SERIAL UNIT IN
NUMBER WARRANTY?