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Surface Repair, LLC. FAX Order Form
(To be used if you prefer to order offline)

To order, Call: 1-800-218-2066 or Fax: 1-951-834-9061
Email orders to orders@multitechproducts.com


   Ship To:

Name:                                       
Street address:                                        
City/state/zip:                                        
Phone number:                                        
ITEM
COLOR
PRICE(ea)
x QTY
= SUBTOTAL
Pre-Cleaning Spray
n/a
$6.95
       
                   
Plexus Spray
n/a
$7.95
       
                   
Refinisher Spray *
_____
$16.95
       
                   
High Gloss Clear Overcoat Clear $16.95                            
Nick Fix Touch-up **
_____
$6.95
       
                   
Professional Repair System ***
_____
$29.95
       
                   
         
Shipping & Handling: Less than $30.00.= $7.50, more than $30.00 = $9.00
                   
CA Only, add 7% Tax                    
TOTAL                    

Payment: Visa, MasterCard, check or money order. Sorry, no CODs.

Credit Card:        
Card Type:  ___ Visa   ___ Mastercard
Credit Card number / expiration date:                                                                 
Signature:                                                                 

Colors:
* Refinisher Spray
* * Nick Fix
* * * Repair Systems
    00  Plumbing white     00  Plumbing white     00  Plumbing white
    01  Appliance white     01  Appliance white     01  Appliance white
    41  Almond     41  Almond     41  Almond
    42  Bone     42  Bone     42  Bone
      43  Avocado  
      44  Harvest Gold  
      45  Black