Print, fill it out and fax to (818)886-3436. Back home

Purchase Order

Company Name:______________________________
Address:_____________________________________
City:________________________________________
State:_______________________________________
Zip:_________________________________________
Phone:_______________________________________
Fax:_________________________________________

Contact:_____________________________________
Email:_______________________________________
P/O#:
Date:
Ship By:

-FedEx 2 day $8.50 ( USA )

-FedEx O/N   $14.00 ( USA )

Terms:
Please fax to: New Image Data, Inc. (818)886-3436  -  DLT, DAT drives, parts and repairs

Item

 Description Qty Price

DL07 

DLT7000 leader
(5 pack)

 $90
DL04 DLT4000/2000XT leader (5 pack)
 $90
DL01
DLT1 / VS80(5 Pack)


 $90
.


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Sub Total
Shipping & Handling
Tax
TOTAL

Payment Details

Please indicate your resale number:
Circle only one

Purchaser
_________________

Company Check
Casher Check
Wire Transfer
Credit Card (If credit card, please continue with CC info)
Credit Card Name
(VISA, MC or AMERICAN EXPRESS ONLY)
Card Holders Name
Card Number
Exp Date