AC Drives, DC Drives, Variable Frequency Drives, and Electric Motor Order Form

PRINTABLE ORDER FORM
AC Drives, DC Drives, and Electric Motors
Drive Systems, Inc. Home

Drive and Motor Order Form Instructions:

1) Print out this form.

2) Confirm price, availability, and shipping costs with Drive Systems, Inc.

(Email: drives@drivesys.com * Phone number: 1-281-534-0255)

3) Enter the quantity, make, model, price, and shipping cost.

4) Enter your name, shipping address, and credit card information.

5) Sign the form and fax it to Drive Systems, Inc.

Fax number: 1-281-534-0755

4) This form may be mailed with payment, to:

Drive Systems, Inc.

1606 Windswept Drive

Dickinson, Texas 77539

5) Orders will be acknowledged and processed within 24 hours. Orders paid with checks will be held until the check clears payment.

Item Information:

Quantity
HP

Voltage

Make

Description/Model
Price Each
Total

______ ______ _________ ______________ ____________________________ _________
_______

______ ______ _________ ______________ ____________________________ _________
_______

______ ______ _________ ______________ ____________________________ _________
_______

Shipping Method:

Next Day Air (UPS Red)
Sub-Total
_______

(Circle One)

2nd Day Air (UPS Blue)
Freight
_______

3 - 5 Day Ground
Total
_______

Your name, shipping address, and method of payment:

Your Name: ___________________________ Phone:____________________ Email:_________________

Address:________________________________

Address:________________________________

City:_______________________________ State:___________ Zip:______ Country:_________

Method of payment: ( ) Check enclosed

Circle: x Mastercard x VISA x Discover AmX Card#____________________ Exp Date:___________

xxxCardholder name: ______________________ Complete Address:____________________________________

Total authorized dollar amount: $_________ Signed:______________________ Date:____________

Warranty and Cancellation: Unless specified, the equipment manufaturers' warranties apply. To claim warranty you, the purchaser, must return the items to our company, at the above address, for warranty claim. You are responsible for the shipping costs of items returned under warranty. Items must be returned in the original box. Items that were misused or improperly connected will not qualify for any warranty. Upon warranty inspection and approval of warranty Drive Systems, Inc., at it's sole option, may either replace the item, repair the item, or refund your payment less all shipping costs. Cancellation charges for drives, motors, and other electrical items are 100%. Payment made by credit card cannot be cancelled without written approval from Drives Systems, Inc.

Drive and Motor Order Form Instructions:
	1) Print out this form.
	2) Confirm price, availability, and shipping costs with Drive Systems, Inc.
	(Email: drives@drivesys.com * Phone number: 1-281-534-0255)
	3) Enter the quantity, make, model, price, and shipping cost.
	4) Enter your name, shipping address, and credit card information.
	5) Sign the form and fax it to Drive Systems, Inc.
	Fax number: 1-281-534-0755
	4) This form may be mailed with payment, to:
	Drive Systems, Inc.
	1606 Windswept Drive
	Dickinson, Texas 77539
	5) Orders will be acknowledged and processed within 24 hours. Orders paid with checks will be held until the check clears payment.

Item Information:
Quantity	HP	Voltage	Make	Description/Model	Price Each	Total
______	______	_________	______________	____________________________	_________	_______
______	______	_________	______________	____________________________	_________	_______
______	______	_________	______________	____________________________	_________	_______

			Shipping Method:	Next Day Air (UPS Red)	Sub-Total	_______
			(Circle One)	2nd Day Air (UPS Blue)	Freight	_______
				3 - 5 Day Ground	Total	_______

Your name, shipping address, and method of payment:
Your Name: ___________________________	Phone:____________________	Email:_________________
Address:________________________________
Address:________________________________
City:_______________________________	State:___________ Zip:______	Country:_________

Method of payment:		( ) Check enclosed
Circle: x Mastercard x VISA x Discover AmX	Card#____________________	Exp Date:___________
xxxCardholder name: ______________________	Complete Address:____________________________________
Total authorized dollar amount: $_________	Signed:______________________	Date:____________
Warranty and Cancellation: Unless specified, the equipment manufaturers' warranties apply. To claim warranty you, the purchaser, must return the items to our company, at the above address, for warranty claim. You are responsible for the shipping costs of items returned under warranty. Items must be returned in the original box. Items that were misused or improperly connected will not qualify for any warranty. Upon warranty inspection and approval of warranty Drive Systems, Inc., at it's sole option, may either replace the item, repair the item, or refund your payment less all shipping costs. Cancellation charges for drives, motors, and other electrical items are 100%. Payment made by credit card cannot be cancelled without written approval from Drives Systems, Inc.