Order Information; Shipping Information; Billing Information - Bissell CleanView 3575 Series User Manual

BISSELL CleanView Order Form

Order Information

1
Item Part No. Part Name
1 32074 Style 7 Drive Belt (2 pack)
2 203-1007 Headlight Bulb
3 203-1063 Crevice Tool
4 203-1083 Dusting Brush
5 203-1084 Extension Wand
6 203-1164 Vacuum Hose
7 203-1036 Wire Reinforced
Vacuum Hose Gray
8 203-2012 Wire Reinforced
Vacuum Hose Clear
9 203-2032 Brush Roll
10 203-2013 Power Trak Brush Roll
(Select Models Only)
11 203-1085 Upper Tank Filter
12 203-1073 Pre-Motor Filter
13 203-1009 Post-Motor Filter
14 32076 HEPA Media Post-Motor
Filter (Select Models Only)
Sales tax based on delivery address
AR, AZ, CA, FL, GA, IL, KS, MA, MD, MI, MN, MO,
NC, NE, NJ, NY, OH, PA, TN, TX, UT and WA
residents add applicable sales tax.
Price applicable in continental United States only
Price subject to change without notice
2

Billing Information

Charge: Mastercard
Visa
American Express
Discover
Telephone ________________________________________________________
Account
Number
(include all digits)
Card
Expires
Month Year Signature __________________________________
Or visit BISSELL website - www.bissell.com
Qty. x Unit =
Price
______ $2.99 ______
______ $1.95 ______
______ $2.99 ______
______ $1.70 ______
______ $1.50 ______
______ $8.95 ______
______ $12.95 ______
______ $14.95 ______
______ $15.95 ______
______ $17.95 ______
______ $3.99 ______
______ $1.50 ______
______ $2.95 ______
______ $9.99 ______
SUB TOTAL
Shipping
Sales Tax
Order Total
Enclosed in your envelope
check or money order
payable to BISSELL Homecare, Inc.
(No cash or stamps please)

Shipping Information

3
Total
Ship To ____________________________
______
Address ____________________________
______
______
____________________________
______
______
City ____________________________
______
State ____________ Zip____________
______
______
______
Shipping and Handling
______
______
______
$100.00 to $229.99 = $13.95
______
UPS 2nd Day = above shipping amount + $5.75
UPS Next Day = above shipping amount + $19.95
______
______
______
______
______
MAIL REORDER FORM TO:
BISSELL Homecare Inc.
Mail Order Department
PO Box 3606
Grand Rapids MI 49501
OR FAX TO:
1-616-791-7711
.01 to $4.99 = $2.95
$5.00 to $19.99 = $4.95
$20.00 to $99.99 = $7.95
$230.00 and up = $25.95
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