| Tl: 0800 169 4773 |
| Fx: 01296 394929 |
| © CODRUS™ 2004.
E&OE. |
| |
Please print off this blank form then complete by pen for MAIL order or FAX order.
Please complete clearly in Black Ink and Block Capitals
| Name........................................................................................................ |
| Address:..................................................................................................... |
| ............................................................................................................... |
|
....................................................................................Postcode................ |
| Telephone.................................................................................................. |
| Delivery Address (if different from left)................................................................... |
| ............................................................................................................... |
| .............................................................................Postcode........................ |
| Telephone.................................................................................................. |
| Quantity |
Description |
Price |
| |
CODRUS respirator set, including one new EN136 class
3 gasmask, one new ABEK2P3 canister filter and instruction booklet @ £178.00
(incl VAT)each. |
|
| |
Additional ABEK2P3 Canister Filters @
£ 26.50 (incl VAT) each |
|
| |
CODRUS SCBA child respirator
set @ £495.00 (incl VAT) each |
|
| |
CODRUS Protective Suit @
£58.00 (incl VAT) each, specify size [S][M][L][XL][XXL] |
|
| |
Delivery charge : UK £10.00 Europe £CALL,
Worldwide £CALL |
|
| |
TOTAL |
|
Please be advised that your order may be subject to your
country's import duty and tax if you live outside the EU.
Methods of Payment
Cheque or Postal order : Please make cheques payable
to CODRUS and send them with your order to the address below.
Credit/Debit cards : We accept Visa/Mastercard/Visa
Delta/Switch/Solo (please delete). If new style Switch card, please give
Valid From...../......
| I authorise you to debit my card no.
|
|
| Expiry date |
|
Issue No. (Switch only) |
|
| Name and Address of Cardholder (if different
from above)................................................................................................ |
| ......................................................................................................... |
|
Signature..................................................................................... |
Thank you for your order.
To Order
|
By POST: Send
your completed order form to:
CODRUS, Unit 33, Edison Rd, Rabans Lane
Industrial Estate, Aylesbury, Bucks. United Kingdom HP19 8TE. |
By FAX
01296 394929 (24 Hours) |
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