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PRODUCT ORDER FORM
Please complete the following form and submit it via email, fax or mail.
If you have any questions concerning your request, feel free to
contact us via
email
or call us at the above number.
Remember, use the
TAB KEY or MOUSE
to move within the form.
The ENTER key will submit the form prematurely.
All
Customer Information
must be completed
to efficiently process your order.
P.O. #
Date:
Account #:
BILL TO :
Name
:
Address:
.
City:
.
State/Prov.:
.
Zip/Postal:
ountry:
P
hone:
Email:
S
HIP TO:
(if different)
N
ame
:
Address:
.
C
ity:
.
State/Prov.:
.
Zip/Postal:
Country:
.
P
hone:
Email:
The Comfort Makers®
( 6 per carton per color)
Lumbar Supports
Seat/Back Cushions
Qty
Part #
Color
Qty
Part #
Color
ctn.
92011
Black
ctn.
91011
Black
ctn.
92041
Grey
ctn.
91041
Grey
Deluxe Lumbar Supports
Deluxe Seat/Back Cushions
Qty
Part #
Color
Qty
Part #
Color
ctn.
92061
Black
ctn.
91061
Black
ctn.
92071
Grey
ctn.
91071
Grey
Shoulder Cushion
(Blister Carded, 6 per carton per size)
Qty
Part #
Size
Color
Qty
Part #
Size
Color
ctn.
99500
1" (25mm)
Black
ctn.
99520
1" (25mm)
Clear
ctn.
99501
1.5" (38mm)
Black
ctn.
99521
1.5" (38mm)
Clear
ctn.
99502
2" (50mm)
Black
ctn.
99522
2" (50mm)
Clear
Cord Away ® Wire Organizer System
( 6 per carton per item, carded)
Bulk Quantities and special order colors available - contact factory
Grommets (Black)
Channels (Black)
Clips (Black)
Qty
Part #
Size
Qty
Part #
Size
Qty
Part #
Size
ctn.
00201
2" dia.
ctn.
00205
J Style x 48"
ctn.
00204
Clips
ctn.
00202
2-3/8" dia.
ctn.
00206
3/4" x 48"
.
.
(6 per card)
ctn.
00203
3-1/8" dia
ctn.
00207
1" x 48"
.
.
.
ctn.
00209
Flexible(2-3/8")
ctn.
00208
1-1/2" x 48"
.
.
.
Fold Open Channel
(Boxed, 6 boxes per carton)
Adjustable Organizer
(Boxed, 6 boxes per carton)
.
.
.
Qty
Part #
Color
Qty
Part #
Size
.
.
.
ctn.
00210
White
ctn.
00200
6" Self-Adhesive
.
.
.
ctn.
00211
Black
.
.
.
Doorstops
( 6 per carton per item, carded)
Big Foot®
(12 per carton per color)
Giant Foot®
(6 per carton per color)
ColorStops
(12 per carton per color)
Qty
Part #
Color
Qty
Part #
Color
Qty
Part #
Color
ctn.
00900
Beige
ctn.
00964
Brown
ctn.
00910
Red
ctn.
00920
Brown
ctn.
00965
Orange
ctn.
00911
Yellow
ctn.
00941
Grey
ctn.
00966
Yellow
ctn.
00912
Green
Magnetic Giant Foot®
(polybagged with header 6 per carton)
ctn.
00913
Beige
ctn.
00914
Blue
ctn.
00976
Yellow
.
.
.
ctn.
00916
Brow
Mighty Movers®
(Blister Carded)
Mighty Mighty Movers®
(Boxed)
Bulk Orders Available - Contact Factory
Self-Stick Furniture Sliders
(12 per carton per size)
Reusable Furniture Skate
(4 per box, 6 boxes per carton)
Qty
Part #
Size
Qty
Part #
Color
ctn.
87001
3/4" Dia.
ctn.
87007
5" Dia.
ctn.
87002
1" Dia.
ctn.
87003
2-1/4" Dia.
.
.
.
ctn.
87004
Sm. Triangle
.
.
.
ctn.
87005
Strips
.
.
.
ctn.
87006
Lg. Triangle
.
.
.
RollArounds® Instant Wheels
(Boxed)
( 6 per carton per color)
Qty
Part #
Color
ctn.
17234
Black
ctn.
17264
White
ctn.
17284
Putty
Scratch Guard®
(Blister Carded)
Felt Pads
(12 per carton per size)
Surface Protectors
(12 per carton per size)
Decorative Coasters
(Polybagged, 12 per carton)
Qty
Part #
Size
Qty
Part #
Size
Qty
Part #
Size
ctn.
88482
Triangles
ctn.
88600
3/4" Dia.
ctn.
80050
One 6"
ctn.
88493
3/4" Dia.
ctn.
88601
1/4" Dia.
ctn.
80051
Two 6"
ctn.
88495
Strips
ctn.
88606
5/16" Dia.
ctn.
80060
One 8"
ctn.
88496
1" Dia.
ctn.
88607
1/2" Dia.
ctn.
80061
Two 8"
ctn.
88497
1-1/2" Dia.
Light Duty Acrylic Felt
(Polybagged w/header card)
(144 bags per carton)
Laptop Protectors
(Blister Carded)
(6 per carton)
ctn.
88498
Pads
ctn.
88499
Combo Pack
ctn.
88470
Asstd Circles
ctn.
88609
6-Clear
6-Black
Protective Bumpers
(Blister Carded,
6 Cards/carton)
Wheel Covers
(Boxed, 6 Boxes per carton)
Quiet Feet
(Bagged, 12 bags per carton)
Qty
Part #
Size
Qty
Part #
Size
Qty
Part #
Size
ctn.
88611
1/2" Dia.
ctn.
87009
Fits 1-3/4" to 2-1/8"
ctn.
88847
100 ea 1-1/2" Circles
Wobble Stopper Wedge
(Blister Carded)
(12 Cards per carton)
Qty
Part #
Color
ctn.
01141
Opaque
Hip-Clip Bottle Caddy
(Carded, 12/carton per color)
(Bulk, 48 piece min.)
Clip Strip
Qty
Part #
Color
Qty
Part #
Color
Qty
Part #
Color
ctn.
15900
Red
ea.
05590
Red
ea.
15502
Assorted
ctn.
15901
Blue
ea.
05591
Blue
.
.
(4 of six different colors)
ctn.
15902
Beige
ea.
05592
Beige
.
.
.
ctn.
15903
Black
ea.
05593
Black
.
.
.
ctn.
15904
Pink
ea.
05594
Pink
..
..
..
ctn.
15905
Green
ea.
05595
Green
..
..
..
ReStor-It
®
Repair Kits
Furniture Touch-Up Kit
(Boxed,
6 Boxes per carton)
Leather Cleaning Cloth
(Bagged,
12 Bags per carton)
Qty
Part #
Description
Qty
Part #
Description
ctn.
18000
Marker/Filler Stick Assortment
ea.
18010
2 Cloths/Bag
Stain Buster™ Fabric Cleaner
(Bottle,
6 Bottles per carton)
Stain Buster™ Leather Cleaner
(Boxed,
6 Boxes per carton)
Qty
Part #
Size
Qty
Part #
Size
ctn.
18070
8 oz. bottle
ea.
18071
8 oz bottle and sponge
Leather/Vinyl Repair Kit
(Boxed,
6 Boxes per carton)
Fix-A-Chip Repair Kit
(Boxed,
6 Boxes per carton)
Qty
Part #
Size
Qty
Part #
Size
ctn.
18073
Assortment
ea.
18074
Assortment
Fabric Upholstery Repair Kit
(Boxed,
6 Boxes per carton)
Leather/Vinyl Color Kit
(Boxed,
6 Boxes per carton)
Qty
Part #
Size
Qty
Part #
Size
ctn.
18075
Assortment
ea.
18076
Assortment
Fabric/Upholstery Color Kit
(Boxed,
6 Boxes per carton)
..
..
..
Qty
Part #
Size
..
..
..
ctn.
18077
Assortment
Stor-It
®
Hanging CD File
(Sleeved,
6 per carton)
CD/DVD Organizer
(Sleeved,
6 per carton)
Qty
Part #
Description
Qty
Part #
Size
ctn.
10300
Holds 24 CDs
ea.
10301
Holds 8 CDs/DVDs
Travel Files™ Receipt Organizer
(
6 per carton)
Qty
Part #
Color
ctn.
00300
Black
Display Units
Floor Displays
Qty
Part #
Display Description
Includes:
Quantity
Item No.
Description
00300FD
Travel Files Receipt Organizer
48 pkgs
0300
Receipt Organizer
17134FD
RollArounds Instant Wheels
40 pkgs
17134
Black, Set/4
29200FD
Self Adjusting Organizer
60 pkgs
29200
6" Organizer
29703
HIP-CLIP Bottle Holder
96 pkgs
Assorted
Assorted Colors
15502FD
HIP-CLIP Bottle Holder
96 pkgs
15502
(4) 24 Piece Clipstrips
29704
Color Stops No-Slip Doorstops
40 pkgs
Assorted
Assorted Colors
29705
Scratch Goard® Decorative Coasters
40 pkgs
80050
6" Coasters (1 per)
40 pkgs
80060
8" Coasters (1 per)
29706
Mighty Movers® Furniture Sliders
12 pkgs
87001
3/4" dia. Self-Stick
24 pkgs
87002
1" dia. Self-Stick
6 pkgs
87003
2-1/4" dia. Self-Stick
8 pkgs
87004
Self-Stick Triangles
6 pkgs
87005
Self-Stick Strips
6 pkgs
87007
5" dia. Reusable
29707
Cord Away® Wire Management System
12 pkgs
29200
6" Organizer
8 pkgs
00201
2" Grommet
8 pkgs
00202
2-3/8" Grommet
4 pkgs
00203
23-1/8" Grommet
8 pkgs
00209
Flexible Grommet
4 pkgs
00204
Wire Clips
6 pkgs
00211
Fold-Open Channel
29708
Scratch Guard® Self-Stick Felt Pads
24 pkgs
88493
3/4" dia. Circles
24 pkgs
88496
1" dia. Circles
24 pkgs
88497
1-1/2" dia. Circles
16 pkgs
88499
Combo Packs
29711
ShoulderCushion® Shoulder Strap Holder
18 pkgs
99500
1" Strap Holder
18 pkgs
99501
1.5" Strap Holder
12 pkgs
99502
2" Strap Holder
29712
Stor-It® CD/DVD Organizers
40 pkgs
80050
6" Coasters (1 per)
40 pkgs
80060
8" Coasters (1 per)
29713
ReStor-It® Repair Kits
6 pkgs
18000
Touchup Kit
9 pkgs
18073
Leather/Vinyl Kit
9 pkgs
18074
Fix-A-Chip Kit
9 pkgs
18075
Fabric Upholstery Kit
Corrugated Counter Displays
Qty
Part #
Display Description
Includes:
Quantity
Item No.
Description
15501
HIP-CLIP®
36 piece Counter Display
6 ea
05590
Red Hip-Clip
6 ea
05591
Blue Hip-Clip
6 ea
05592
Beige Hip-Clip
6 ea
05593
Black Hip-Clip
6 ea
05594
Pink Hip-Clip
6 ea
05595
Green Hip-Clip
15503
HIP-CLIP®
144 piece Counter Display
24 ea
05590
Red Hip-Clip
24 ea
05591
Blue Hip-Clip
24 ea
05592
Beige Hip-Clip
24 ea
05593
Black Hip-Clip
24 ea
05594
Pink Hip-Clip
24 ea
05595
Green Hip-Clip
18200
ReStor-It® Counter Display
10 bottles
18070
Fabric Cleaner
8 pkgs
18073
Leather/Vinyl Kit
8 pkgs
18074
Fix-A-Chip Kit
8 pkgs
18075
Fabric Upholstery Kit
88590
Scratch Guard Felt
12 pkgs
88594
3/4" dia. Circles
12 pkgs
88596
1" dia. Circles
12 pkgs
88597
1-1/2" dia. Circles
12 pkgs
88598
4-1/2" dia. Pads
Corrugated Counter Displays
Qty
Part #
Display Description
Includes:
Quantity
Item No.
Description
01998
ColorStops® Doorstop
8 pkgs
00910
Red Doorstop
8 pkgs
00911
Blue Doorstop
8 pkgs
00912
Beige Doorstop
8 pkgs
00913
Black Doorstop
8 pkgs
00914
Pink Doorstop
8 pkgs
00917
Green Doorstop
02020
Cord Away®
Wire Management System
12 pkgs
00201
2" Grommet
12 pkgs
00202
2-3/8" Grommet
12 pkgs
00203
3-1/8" Grommet
12 pkgs
00204
Wire Clips
23000
Get it Movin' Duet Casters
6 pkgs
23600
Metal Base/Carpet
6 pkgs
23601
Wood Base/Carpet
6 pkgs
23602
Metal Base/Hard Floors
6 pkgs
23603
Wood Base/Hard Floors
87025
Mighty Movers® Furniture Sliders
6 pkgs
87001
3/4" dia. Self-Stick
12 pkgs
87002
1" dia. Self-Stick
12 pkgs
87003
2-1/4" dia. Self-Stick
6 pkgs
87004
Self-Stick Triangles
6 pkgs
87005
Self-Stick Strips
88592
Floor Savers
12 pkgs
87002
1" Furniture Movers
12 pkgs
87003
2-1/4" Furniture Movers
12 pkgs
88600
Surface Protectors
6 pkgs
17234
Instant Wheels, Black
12 pkgs
88496
1" Felt Circles
12 pkgs
88499
Felt Combo Pack
88595
Floor Savers
12 pkgs
88493
3/4" Felt Circles
12 pkgs
88496
1" Felt Circles
12 pkgs
88600
Surface Protectors
12 pkgs
88495
3/4" x 6" Felt Strips
12 pkgs
88497
1-1/2" Felt Circles
12 pkgs
88499
Felt Combo Pack
Wire Spinner Racks
Qty
Part #
Display Description
Includes:
Quantity
Item No.
Description
02030
Cord Away®
Wire Management System
12 pkgs
00201
2" Grommet
12 pkgs
00202
2-3/8" Grommet
12 pkgs
00203
3-1/8" Grommet
12 pkgs
00204
Wire Clips
12 pkgs
00205
"J" Style Channel
12 pkgs
00206
3/4" Locking Channel
12 pkgs
00207
1" Locking Channel
12 pkgs
00207
1-1/2" Locking Channel
Shipping Information
Please sent products via:
Select One
UPS- Reg. Ground
UPS- Red Label next day air
UPS- Blue Label 2nd day air
UPS- Orange Label 3nd day air
UPS- Saturday Del.
Fedex(see below)
Truck
Other(see below)
Your UPS #:
Your FEDEX #:
If other please state:
Sorry, No COD
Special Instructions:
© Copyright 2008 by Master Manufacturing Co. & Web Centers of America, Inc. All right reserved.