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MULTI-SHIPMENTS ORDER FORM 

RELEASE AND ORDER FORM.  Please enter ALL REQUIRED information fields and then submit this form for your order that requires multiple scheduled shipments (more than 1 scheduled shipment).  This form must be on file BEFORE your order is accepted and authorized for the first shipment. 

You must meet our Payment Plan Options and be pre-approved for us to process this order.

For important information about this type of order, accounting application forms, getting pre-authorized approval, etc., see the LINKS LIST at the left.

EACH PART NUMBER ORDER MUST BE ON A SEPARATE ORDER FORM AND APPROVED INDIVIDUALLY... EVEN THOUGH THEY MAY BE SHIPPED TOGETHER. ALL forms must be signed/validated to be processed.

Bold fields are required

Today's Date

 

If More than 1 Part Ordered

 

QUOTE #

 

Purchase Order #

 

Payment Method

 

Company Name (this Division)

 

Contact Name

 

Email:
Accounts Payable Email

 

Accounts Payable Phone #

 

Accounts Payable FAX #

 

Bill to Company

 

Bill to Address

 

Bill to City

 

Bill to State

 

Bill to ZIP
 
Bill to Country
 
Ship to Company Name
 
Ship to ATTN:
 
Ship to Address
 
Ship to City

 

Ship to State

 

Ship to ZIP

 

Ship to Country

 

ALL SHIPMENTS WILL BE MADE BY GROUND. SCHEDULE YOUR SHIPMENTS TO ALLOW FOR SHIPMENT TRAVEL TIME.
Your Shipper Account # - if required

 

Comments or Special Information

 

Part Number

 

Total Order QTY being placed

 

Total # of Shipments Scheduled

 

Shipments will be divided equally.
State the Dates to RELEASE the parts for shipping.
A maximum of 18 shipments can be scheduled on each form.
DATE #1

 

DATE #2

 

DATE #3

 

DATE #4

 

DATE #5

 

DATE #6

 

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
DATE #7

 

DATE #8

 

DATE #9

 

DATE #10

 

DATE #11

 

DATE #12

 

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
DATE #13

 

DATE #14

 

DATE #15

 

DATE #16

 

DATE #17

 

DATE #18

 

CUSTOMER's DECLARATION OF AGREEMENT

I (the customer) DECLARE THAT:

(a) OUR QUOTED PRICING IS BASED UPON THE TOTAL QUANTITY OF PARTS BEING INVOICED;

(b) THIS COMPLETE ORDER WILL BE PURCHASED AS STATED ABOVE;

(c) PRE-PAYMENT FOR EACH SHIPMENT WILL BE MADE AS PRE-APPROVED WITHIN THE TIME PERIOD STATED IN THE SALES INVOICE.  THE FIRST SHIPMENT INVOICE WILL INCLUDE THE PRE-PAYMENT AMOUNT OF SHIPMENTS 1 & 2.  AFTER THAT, EACH INVOICE WILL COVER ONLY ONE SHIPMENT.

(d) SHOULD TOTAL QUANTITY NOT BE REQUIRED AS REQUESTED, WE AGREE:

           (1) TO NOTIFY PLASTIC FASTENERS IMMEDIATELY UPON DECIDING NOT TO CONTINUE THIS ORDER AS PROMISED;

           (2) TO ACCEPT AN ADJUSTED PER/ITEM PRICING INVOICE -- BASED UPON THE AMOUNT OF PARTS ACTUALLY SHIPPED;  (this per/item cost will be higher than the total order per item cost -- since the total order will not be completely shipped - and will have to be requoted for the smaller quantity - shipped total).

           (3) TO PAY -- immediately -- THE ADJUSTED PER/ITEM PRICING OF PARTS SHIPPED; 

           (4) AND, WILL PAY ANY UNPAID BALANCES IMMEDIATELY - AS INVOICED.

NORMAL BUSINESS PROTOCOL IS AGREED TO BY SIGNING THIS AGREEMENT.

CHECKING THE 'YES' BOX IS REQUIRED TO PROCESS THIS ORDER.

YES - I AGREE

 

State your position with this company

 

Type your FULL NAME

 

Date of this signing

 

   
 

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Office:  828.626.2773           FAX: 828.694.0654

Weaverville, NC  28787

sales@pf-dist.com