CMT  PURCHASE ORDER FORM CMTINC.COM
413 SW Jefferson Ave.
Corvallis, OR 97333 USA

Email: support@cmtinc.com
FAX: (541)752-4117

Company Name: _______________________________________________________
Invoicing Address: Attention: ____________________________
  _______________________________________________________
City ____________________________ State ________________ ZIP _______________
Phone: _______________________ Fax: _______________________
Shipping Address:  Attention: ____________________________
(if different) _______________________________________________________
(No P.O. Boxes please)
City ____________________________ State ________________ ZIP _______________
Phone for Shipping Address: _______________________
Email: __________________________ Contact: (if different) ________________________
CMT Part #

Item / Description

 Qty List Price Extended
______________________ _____________________ ___ ___________ ___________
______________________ _____________________ ___ ___________ ___________
______________________ _____________________ ___ ___________ ___________
Shipping & Handling Charge:
___________
  

Total :

 ___________

** Please figure $15 for regular 2-DAY domestic shipment of a small package (up to 2 lbs).
Standard domestic shipment is via FedEx 2-DAY service.
 Any duty and taxes are the responsibility of the purchaser.

If purchasing software upgrade or hard key, please provide the serial number from the software CD:
____________________________

Also specify the type of hard key: parallel printer port ________, or USB port ________.

Payment Terms (circle):
Net 30
Check
Wire Transfer

 

Signature for Authorization : _____________________________

Date:_______________
PO# (if applicable):  _______________

Please click on File/Print to print out the form then FAX completed form to (541) 752-4117. For order assistance call CMT at (541) 752-5456.