Columbia Electronics International, Inc.                   3 720 Groves Place t  Somis  t  CA  93066-0960  t  Phone  805-386-2312 t  FAX  805-386-2314                                                    E-mail: [email protected]                                       hours: Monday thru Friday 8 AM to  4 PM California time

)Name (please print	Ship To ( if different from billing address) Name:
Company or organization:	Company  or organization:
Street address:	Street address:
City :                                                                             State:              Zip	City:                                                                                     State:                    Zip:
Phone:  Day:                                    Evening:                                fax:	Email:
Ship via:  (check 1st & 2nd choice)  UPS Ground__, Federal Express Ground__, Parcel Post__, Priority Mail__, Air freight__, Best way__, Other:__________________

Date	Order Ref.	Amount Sent		Payment by: (Check one)  Money order__, Cash__, Check__, Credit card__, Pay Pal __, Wire__
		$		Or other: (explain):
Credit card type: Visa__,  Mastercard__				Credit card No.                                                              Expires  Mo.___   &  Yr.____
Name on credit card :                                                                      Signature of card holder:
Card billing address:                                                                                                                                      Card  Security Code:
		Minimum order $50.00 excluding shipping &   tax!		Outlet Store  prices are only  for shipment within the United States! Military  nomenclature  electronics equipment and parts thereof require a special export license that is very  time consuming and costly to process.
Shipping   rate calculators				Please allow for shipping charges.  Any overages will be promptly refunded. COD orders permitted  only at our discretion.  COD fees are about $10.00 Single items that exceed 150 Lb must be shipped via truck or air freight!! Please consult us for a quote on the shipping charges if in doubt.

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Total  of items ordered (Note: Minimum order excluding tax & shipping is $50.00)
Sales tax ( 7.25%  of above charged on all shipments within California)
Shipping, insurance  and handling charges (overages will be promptly refunded)
Total

Terms: Net cash. All trade and cash discounts have been deducted from the prices We reserve the right to hold up shipment for 14 days on orders accompanied with personal or company checks until we are sure that they have cleared the banks.   For faster delivery uses a credit card or send guaranteed funds. Normal delivery  is about three days for items sold untested.  Delivery on tested sand guaranteed items quoted upon request. All prices supersede  previously published prices and are subject to change without notice.

All prices are net, F.O.B. Somis, California. Insurance will be included in the shipping charges. Any claims for loss or damage must be made promptly  with the carrier  buy the buyer. See further instructions on Terms & Conditions Page

orders can be placed via phone, mail, fax. or Email.  Please print this order form and  mail, fax or Email a scanned copy of  your order. Note: Some items are only available in very limited unities. and can't be replaced.  Consult us prior to placing an order for a stock check. Thank you for your interest in our products.  Paul Keys President W6QDK