Special Order Form

SPECIAL ORDER

ORDER ENTRY CUSTOMER#      

ORDER DATE 2/9/2004

SHIP DATE      

SOLD TO NAME

ORDER TYPE

TERMS      

PENINSULAR PAPER COMPANY SHIP SALES ID ROUTE STOP VIA Our truck        

SHIP TO NUMBER    

     

ADDRESS       CITY      

STATE / ZIP      

SHIP TO NAME

ORDER#

CONTRACT #1

     

     

ADDRESS 1      

CONTRACT #2      

ADDRESS 2      

PO #      

CITY      

STATE   

ZIP      

CREDIT APPV.

SPECIAL INSTRUCTIONS 1)     ______________________________________________________________________________________________________________ 2)     ______________________________________________________________________________________________________________ ORDER ENTRY COMMENTS:     _______________________________________________________________________________________ ITEM NUMBER

DESCRIPTION

QUAN

U/M

CODE

PRICE

     

     

     

CS

     

     

TAX Y/N Yes

     ____________________________________________________________________________________________P.O. COST      _____      _________________________________________________________________________________________LOADED COST     _____      __________________________________________________________________________DEVIATED/LAST/SPECIAL COST     _____ ITEM NUMBER

DESCRIPTION

QUAN

U/M

CODE

PRICE

     

     

     

CS

     

     

TAX Y/N Yes

     ____________________________________________________________________________________________P.O. COST      _____      _________________________________________________________________________________________LOADED COST     _____      __________________________________________________________________________DEVIATED/LAST/SPECIAL COST     _____ ITEM NUMBER

DESCRIPTION

QUAN

U/M

CODE

PRICE

     

     

     

CS

     

     

TAX Y/N Yes

     ____________________________________________________________________________________________P.O. COST      _____      _________________________________________________________________________________________LOADED COST     _____      __________________________________________________________________________DEVIATED/LAST/SPECIAL COST     _____ SIGNED:

NAME & TITLE:

                                    PLEASE PRINT

_

SPECIAL ORDER MERCHANDISE IS NOT RETURNABLE (other than that found to be defective in manufacture.) The above signed customer or authorized agent of same hereby acknowledges that the order placed herein is a “special order” for goods to be specifically ordered, manufactured, printed, cut or in some way modified for the customer’s needs, thereby rendering them unsuitable for sale to others. Therefore, the above signed customer, in consideration of the acceptance of this “special order” by Peninsular Paper Company, agrees to be responsible in the event of cancellation of this order by the customer for all costs incurred by Peninsular Paper Company in the handling and filling of the order through the date that Peninsular Paper Company receives and acknowledges the written cancellation of this “special order”. The above signed customer further acknowledges and agrees that in the event cancellation is requested after ordering, manufacturing, printing, cutting, or modifying of the goods is completed that customer will be responsible for the entire costs reflected on this order including all costs of collection of monies due from this order including a reasonable attorney’s fee. All prices, quotations, and/or contracts subject to contingencies of transportation, strikes, acts of God and any other unavoidable accidents or causes beyond our control. All quotations are based on immediate acceptance and subject to change without further notice.

ORDER ENTRY

SPECIAL ORDER

PENINSULAR PAPER COMPANY

All claims must be filed within 24 hours. Merchandise accepted for return after 15 days subject to restocking charge. Any merchandise accepted for return is accepted for credit or exchange only; No Cash Refunds. Accounts not paid within 30 days subject to 1 ½% per month service charge on unpaid balance. MINIMUM BILLING $75.00. Should it become necessary to collect monies due resulting from this sale, you hereby agree to pay all costs of such collection, including a reasonable attorney’s fee. MAIL REMITTANCE TO P.O. BOX 1197, TAMPA, FL 33601