HAYBALE RENTAL AND SALES FORM

TEMPORARILY OUT OF STOCK DUE TO
MATERIAL AVAILABILITY

Name of Purchaser *

Company or Organization *

Address *

City *

State *

Zip Code *

Phone *

Mobile # *

Email *

Fax *

Requested Delivery Date *

Delivery Address if different *

City *

State *

Zip Code *

Is the delivery a business or residence ? *

Using client's delivery service provider company? *

City *

State *

Zip Code *

Delivery Service Name *

Delivery Service Acct Number *

Delivery Hours Monday - Friday *

PLACE YOUR ORDER IN THE FIELDS BELOW

Quantity

Unit Size and / or specific description

Quantity

Unit Size and / or specific description

Quantity

Unit Size and / or specific description

Quantity

Unit Size and / or specific description

Quantity

Unit Size and / or specific description

Comment or Message

* ALL ORDERS MUST BE PAID IN FULL BEFORE DELIVERY *

* ALL SALES ARE FINAL *

NAME AS IT APPEARS ON CREDIT CARD

BILLING ADDRESS

CITY

STATE

ZIP CODE

CREDIT CARD TYPE

EXPIRATION DATE

CSV CODE

SIGN HERE

DATE

WE APPRECIATE AND THANK YOU FOR YOUR BUSINESS !

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