Page 67 - Avron_2023 Food Catalogue_Regional

HEAD OFFICE: EASTERN REGION OFFICE: WESTERN REGION OFFICE:
277 Basaltic Road, 3524 boul. Poirier, 708 Chester Road
Concord, ON, L4K 4W8 St-Laurent, QC, H4R 2J5 Delta, BC, V3M 6J1
Tel: 905.761.9752, Toll Free: 1.800.997.9752 Tel: 514.904.0575, Toll Free: 1.855.535.0575 Tel: 604.526.1482, Toll Free: 1.877.773.9993
Fax: 905.761.9754, Toll Free Fax: 1.800.595.9754 Fax: 514.904.0658 Fax: 604.525.1293
E-mail: sales@avron.ca E-mail: avronquebec@avron.ca E-mail: saleswest@avron.ca
ORDER FORM

CUSTOMER INFORMATION

Company Name _______________________________________________________ Customer Number (If known) __________________________________________
Contact Name _____________________________________________________________________________________________________________________________________
Payment Options: Credit Card Cheque Cash Delivery Date
Credit Cart Type _______________________________________________________ Credit Cart Number ____________________________________________________
Expiry Date ____________________________________________________________ Signature _____________________________________________________________
Billing Address _________________________________________________________ Shipping Address ______________________________________________________
_________________________________________________________________________ ________________________________________________________________________
_________________________________________________________________________ ________________________________________________________________________
Phone __________________________________ Fax ______________________________________ Email __________________________________________________
ORDER INFORMATION
CODE ITEM DESCRIPTION SIZE QUANTITY PRICE
1 _____________ _____________________________________________________________________ ________________ _________________ _______________
2 _____________ _____________________________________________________________________ ________________ _________________ _______________
3 _____________ _____________________________________________________________________ ________________ _________________ _______________
4 _____________ _____________________________________________________________________ ________________ _________________ _______________
5 _____________ _____________________________________________________________________ ________________ _________________ _______________
6 _____________ _____________________________________________________________________ ________________ _________________ _______________
7 _____________ _____________________________________________________________________ ________________ _________________ _______________
8 _____________ _____________________________________________________________________ ________________ _________________ _______________
9 _____________ _____________________________________________________________________ ________________ _________________ _______________
10 _____________ _____________________________________________________________________ ________________ _________________ _______________
11 _____________ _____________________________________________________________________ ________________ _________________ _______________
12 _____________ _____________________________________________________________________ ________________ _________________ _______________
13 _____________ _____________________________________________________________________ ________________ _________________ _______________
14 _____________ _____________________________________________________________________ ________________ _________________ _______________
15 _____________ _____________________________________________________________________ ________________ _________________ _______________
16 _____________ _____________________________________________________________________ ________________ _________________ _______________
17 _____________ _____________________________________________________________________ ________________ _________________ _______________
18 _____________ _____________________________________________________________________ ________________ _________________ _______________
19 _____________ _____________________________________________________________________ ________________ _________________ _______________
20 _____________ _____________________________________________________________________ ________________ _________________ _______________

TOTAL _______________
Special Instructions ________________________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________________________________________
I hereby acknowledge the submission of this order.
For Walk-In Orders Only: ____________________________________________________________________________________________________________________________
Title ________________________________________________________________ Date ________________________________________________________________________

FOR COMPANY USE ONLY
Date Order Taken _____________________________________ Date Entered _________________________________ CSR ______________________________