| Surya Incense Company WHOLESALE . You can print this out and mail: 724 Peaceful Valley, Lyons, CO, 80540, U.S.A fax:303-747-2363 call:(toll free)1-888-540-2500 e-mail: sita@suryatrading.com |
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| Name: Address: City: State: Zip Code: Date: |
Phone: FAX: Email: Contact: Resale # : |
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| Item No. | Description | Rate | Qty. | Extn. Price |
|---|---|---|---|---|
| 10811 | Master Pack | $180/ea | _ | $ |
| 10812 | Half Master Pack | $91/ea | _ | $ |
| 10810 | Studio Pack | $46/ea | _ | $ |
| 10815 | Amber | $16/doz | _ | $ |
| 10820 | Euphoria | $16/doz | _ | $ |
| 10825 | Forest Champa | $16/doz | _ | $ |
| 10830 | Jasmine | $16/doz | _ | $ |
| 10835 | Maharaja | $16/doz | _ | $ |
| 10840 | Nag Champa | $16/doz | _ | $ |
| 10850 | Saffron Sandal | $16/doz | _ | $ |
| 10855 | Sampler Darbari | $16/doz | _ | $ |
| 10860 | Sampler Masala | $16/doz | _ | $ |
| 10902 | Rose | $16/doz | $ | |
| 10865 | Royal Champa | $16/doz | _ | $ |
| 10870 | Sandalwood Supreme | $16/doz | _ | $ |
| 10890 | Mysore Sandal Cones | $16/doz | _ | $ |
| 10081 | Brass Incense Burner | $9/doz | _ | $ |
| Sub Total | _ | $ | ||
| Free Shipping within the U.S.A. | COD / S&H | $ | ||
 30 Day net |
Total | $ | ||
| Payment enclosed COD VISA MASTER DISCOVER |
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| Card Number Expiry date: __ / __ |
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| Authorized Signature: | ||||