Links For Canada Click Below
Display Machine Printable
Order Form For Canadian Customers
156 Enfield Place, Unit 1605, Mississauga, ON L5B 4L8
Tel: 905.270.6459 Fax: 905.858.6840
DISPLAY MACHINE PACKAGES:
$2 (2 x $1 coins) mechanism machines @ $______ each = $
$3
(3 x $1 coins) mechanism machines @ $______ each = $
$4
(2 x $2 coins) mechanism machines @ $______ each = $
ABOVE PRICE
INCLUDES
DISPLAY MACHINE, DECALS, DUREX®
CONDOMS (SEE BELOW) & SHIPPING.
MACHINE PARTS: (Shipping Included)
Extra $1 coin
kits for mechanism @ $25 each = $
Extra $2 coin
kits for mechanism @ $25 each = $
New sets of
machine decals @ $10 each = $
Subtotal = $
TAXES: NS, NB, NL HST 15% of subtotal = $
TAXES: All other
provinces, GST 7% of subtotal = $
In provinces other than NS,NB,NL you may be required to self assess for PST
PRICES SUBJECT
TO CHANGE WITHOUT NOTICE Total
Payment = $
INCLUDED with
each machine package are 72 packs DUREX®
Sheik Sensi-Creme, OR, 48 packs
DUREX® Tropical, OR,
48 packs DUREX®
Intense Sensation, OR, 48 packs DUREX®
Performax.
Specify your requirements here:............................................................
Mail form with a cheque or payment by wire transfer or Western Union Money Transfer.
Check / money order attached Yes
Your Shipping Address
Name:
Phone #
Address:
Postal Code:
Signature: Date:
Copyright © 2003 Quality Condoms Vending Ltd. Last modified: 16-Oct-2005