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Order Supplies Form / Purchase Agreement

Please note that this form will be emailed. Contacting us by email is not secure for credit card information. If you would prefer to pay for these supplies by credit card please make the selection below. If you select that option we must contact you for your credit card information when processing your order.
I would like to pay by: Credit Card   Invoice
Shipping Information  
*Customer Name:
*Address:
*City, State & Zip:
*Phone:
*Contact Name:
*Email:

Billing Information (if different from shipping)
Customer Name:
Address:
City, State & Zip:
Phone:
Contact Name:
Email:
   
Order Date: Tax Exempt:   (If Yes #):
PO #: Ordered By:


Rena & Hasler HP Ink Cartridges & Roller Care
QTY
Part #
Lot
Description
Price
C8842A
1 each
Versatile Black Ink Cartridge  -  Black
$38.50
CM-796 KB 1 each Collins Quick Dry Ink Cartridge  -  Black
$38.50
C8715A
1each
Easy Ink (quick dry) Cartridge  -  Black
$43.50
C9007A
1 each
Easy Ink Aqueous (glossy stock)  -  Black
$48.50
C6168A
1 each
Spot Red Ink Cartridge
$45.00
C6169A
1 each
Spot Green Ink Cartridge
$45.00
C6170A 1 each Spot Blue Ink Cartridge
$45.00
2024 1 bottle Rena Care Roller Cleaner
$5.00
94153
1 Can
Compressed Air
$12.75