Lacy West Homepage
Lacy West Jewellery Tools and Supplies
#102 - 480 Smithe Street, Vancouver, British Columbia, Canada,
V6B 3C1
Tel: 604-669-LACY (5229),
Fax: 604-628-4480
Toll Free Phone 1-800-667-4118
Company Name: ____________________ Phone Number:
_______________
Contact Person: __________________ Fax Number:
_________________
Street Address: _________________________________________________
_________________________________________________
City: ___________________________ Province/State:
_______________
Country: _________________________ Postal Code:
_______________
E-Mail: __________________________ WebPage
URL: ________________
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SHIPPING INSTRUCTIONS: Sample
Shipping Costs
Vancouver: (Local Courier - Same/Next Day)
(XpressPost - 1-2 Days)
Canada: (Priority Courier
- Next Day) (XpressPost - 1-2 Days)
(Greyhound
Courier - Days) (Expedited - 2-7 Days)
USA: (Air Mail)
(Surface Mail)
OverSeas: (Purolator - 1-3 Days)
(Air
Mail - Weekish) (Surface Mail - 4-8 Weeks)
Specify Other:__________________________________________________
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BILLING INSTRUCTIONS:
Credit Card: (VISA) (MASTERCARD)
Card #:________________________________
Expiry Date: ________
Name on Card: __________________________
3-Digit Security Code ____
Other: (LACY
WEST ACCOUNT) (COD - only in Canada)
Tax Exemption Numbers : _________________________________________
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CUSTOMER ORDER
Code | Item Description | Quantity | Price/Unit | Total Price