Rugate Technologies, Inc. 2006.

Surplus Optical Components Order Form

# of Items	Part Number	Dia (in)	Description of Item	Quantity	Price
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Subtotal
Sales Tax (6% in CT)
Total Before Shipping

SHIPPING: Unless otherwise directed, shipment will be by the method Rugate Technologies, Inc. deems appropriate, F.O.B. Rugate Technologies' offices. Shipping costs are prepaid and added to the customer's invoice.
PRICING: All prices are in U.S. dollars. Surplus optics are available in limited quantities and are subject to prior sale. Prices are subject to change without notice. Listed prices do not include taxes, duties, freight, or insurance charges. We are not responsible for typographical errors.
PAYMENT: Payment may be made by credit card, through PayPal or Billpoint or payment may be prepaid, COD, Net 10 for approved purchase orders.
WARRANTY: The buyer has the right to return the products to Rugate Technologies, within 30 days after receipt, for replacement or full credit.

Please describe the payment option you would prefer to use and we will contact you with specific arrangements:

Order will be shipped to the following address:
Name:
Company:
Phone:
Fax:
e-mail:
Address: