Order By:      

       
Please Xerox              
For Future Use              
               
  ITEMS ORDERED  

ORDER FORM
4 Easy Ways to Order!

PRODUCT
NUMBER

 PRODUCT NAME

QTY.
EACH

COST

TOTAL
1          
2          
3          
4          
5          
6          
7          
8          
9          
10          
11          
12          
13          
14          
15          
16          
17          
18          
19          
20          
21          
1. PHONE
809-689-7854
2. FAX
 850-454-0101
3. E-MAIL
melania@LarimarAAA.com
3. E-MAIL
MAIL FORM TO:
Caribbean Larimar
 
SHIPPING
We Ship Either insured U.S. Postal Priority Mail.  All merchandise is fully insured against loss or damage.  Insurance claim forms must be filled by you and submitted for approval to the postal authority if shipping Priority, fee will be $10.00 under $300.00 purchase and $15.00 if over.  Express Mail charged as is.
     

METHOD OF PAYMENT
TOTAL MERCHANDISE  
SHIPPING (See Sidebar)  
GRAND TOTAL  
ADDRESS (IF DIFFERENT FROM ABOVE)
 
Check
 
Visa
 
Master Card
Important: Credit Card Customers indicate address
where statements are received.
 
Money Order
 
COD    
Name