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Ordering Information - print this form it will be two pages - use 1 sheet of paper on both sides (or you can "Edit", "Select All", "Copy" and "Paste" into Word or other program and fill in the info) and mail it with payment (check, money order, MasterCard, Visa), fax it with credit card info, e-mail with info or call us and we can do it the old fashioned way.

NAME _______________________________________________________

ADDRESS _____________________________________________________

CITY, STATE ____________________________________ ZIP __________

PHONE ______________________  E-MAIL _________________________

CAR INFORMATION:

YEAR ___________    MAKE _________________    MODEL _____________

PAINT CODE  _________________  COLOR NAME _____________________

PAYMENT OF   $___________________  IS ENCLOSED  -   PERSONAL CHECK ____        MONEY ORDER ____ 

                                            - OR-

PLEASE USE MY CREDIT CARD:               VISA ____        MASTERCARD  ____

ACC'T # ______________________________________  EXP DATE _________

SIGNATURE ____________________________________________________

QUANTITY /  PRODUCT REQUESTED         PRICE EACH            TOTAL

____ B-I-C BOTTLES    COLOR                 @    7.98    =    _______________

____ B-I-C BOTTLES    CLEAR                  @    6.98    =    _______________

____ B-I-C BOTTLES    PRIMER                @    5.98    =    _______________

____ B-I-C BOTTLES    RUST REMOVER    @    4.98    =    _______________

____ 12 oz SPRAY        COLOR                @  14.98   =    _______________

____ 12 oz SPRAY        CLEAR                 @  12.98    =    ________________

____ 16 oz SPRAY      COLOR                  @  19.98    =    ________________

____ 16 oz SPRAY      CLEAR                   @  16.98    =    ________________

____ NEW! Large Spray 2K CLEAR (INFO)@ 24.98    =    ________________

____ 12 oz SPRAY   FILL/SAND PRIMER    @   8.98     =    ________________

____  COLOR & CLEAR (2 SPRAY CAN) COMBO    (1.00)    =    ________________                                                                 

                           TOTAL PRODUCT                       =    _________________

                           FLORIDA ADD 6% SALES TAX      =    _______________

 SHIPPING & HANDLING   

____   BRUSH IN CAP BOTTLES  (FIRST)    @  3.95 = _____ 

____  additional bottles                           @  2.75 =  _____     

____   SPRAY CANS                   (FIRST)    @  6.90  = _____        

____  additional cans                               @  4.90 = _____

                         TOTAL ENCLOSED                                                      ________________

For More Information Contact:
NMB PAINT SALES
15520 W Dixie Hwy

N Miami Beach, FL  33162

Tel: 305.944.2833   //    800.281.0973       FAX: 305.944.3382                         E-MAIL:   INFO 

Hours:                       8:30 - 4:30 EST  Mon - Fri

                        Closed Sat & Sun  as well as most holidays

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Latest update:    Dec 29, 2009