PURCHASE ORDER FROM Order Date:      
Lima Firefighters - Local 334 Ship to: Residence LFD (circle one )
433 S. Main
PO Box 112   211 E Main Street
Lima, OH  45804 Name:      
Coldwater, OH  45828 Address:      
Phone:  1-866-362-3374      
Fax:  1-419-678-3577 City, State  ZIP:      
E-Mail:  embroidery@designsemb.com (for residential shipping)
-see additional charges
              Personalization     Pricing
        Emb Emb Initials Word/Name Lettering    
Item No. Description Size Color Logo # Location First Mid Last w/punctuation Color Qty. Total
                     
                     
                     
                     
                     
                     
                     
                     
                     
                     
                     
                     
   
  Additional Charges   Shipping Charges   Sub Total: $  
      Shipping, Packing  
$3.50 Name, Numbers, or Initials     Total Price of Order and Handling + Shipping: $  
    $0- 25.00 $3.95  
$7.50 Additional Logo Placement $25.01- 50.00 $5.95 + Sales Tax 7%        $  
  -available in all locations size permitting $50.01- 75.00 $7.95  
    $75.01- 125.00 $9.95 = Total $  
$4.00 Add to shipping charges for     $125+   $11.95
  residential delivery
Method of Payment:   Fax your order for credit card
    payment to:  419-678-3577
Credit Card Check (circle one )    
      OR  
Orders must be received by the end of each We accept Visa, MasterCard, American Express, Discover    
month to be processed and shipped for delivery     Mail your order with a check to:
in 7 to 10 days (approximately the 10th of each Credit Card Number:     EMB Designs
month).  Orders will be bulk shipped with     Attn:  Ordering Dept.
individual orders packed separately within Card Exp Date ____/____ Amount:   PO Box 112
to station unless residential delivery requested.     Coldwater, OH  45828
Signature on card