ORDER FORM Enquiry Date Delivery Commencement Date Customer /Company Name ABN Operating Hours Contact Name Delivery Address Postal Address Phone Mobile Licence No. Email Delivery Details How did you hear about us? Account Details: COD Monthly Account Rental Terms Available: YEARLY $110 INCL GST 6 MONTHLY $99 INCL GST MONTHLY $22 INCL GST Items available for rent: RENTAL HOT/COLD CHILLER RENTAL COOL/COLD CHILLER Items available for purchase: WELL - $44.00 INCL GST HOT/COLD CHILLER - $473.00 INCL GST COOL/COLD CHILLER - $418.00 INCL GST CUPS (1000ctn) - $37.40 INCL GST Bottled Water (No GST): 15 LT - $15.50 600ML X 24 CARTON - $16.80 1.5 LT X 12 CARTON - $48.84 I have truthfully provided the above information. I have read and agree to the below conditions link. Send
