127 Banks Avenue
Lafayette, LA  70506
Phone:  1-337-406-0304
Fax:  1-337-406-0306
Email:  PRBA@RodeoBronzes.com

 
Name:______________________________

Address:____________________________

___________________________________

Phone:_____________________________

Driver's Lic.:________________________

 

 Date:___________________________

Salesman:_______________________

Paid By:_________________________

Ship:____________________________

Resale No:_______________________

 

Quantity

Code No.

Description

Unit Price

Amount
         
         
         
         
         
         
         
         
         
         
ALL SALES ARE FINAL!  NO CASH REFUNDS.
Buyer accepts liability for all legal fees and collection cost,
including maximum interest allowed by law.
ALL GOODS REMAIN THE PROPERTY OF
PRBA LTD. UNTIL FULLY PAID FOR.


SIGNED:__________________________________________

NET SALE:

  

Delivery Charges:

  

SUBTOTAL:

  

SALES TAX:

  

GRAND TOTAL:

  

 

*Information that must be filled in to process order:
                Name
                Address (Billing and Shipping)
                Phone #
                Code No.
                Description (Name of the bronze)
                Date
                Paid By (Method of payment-if 
                paying by check, include driver's 
                license number and attach copy of
                driver's license to fax.)
*Delivery Charges are determined by your zip code

*Louisiana residents must add 8% sales tax.

*Order form must be signed.

*Mail payment to:
                PRBA ltd.
                Rodeo Bronzes
                127 Banks Avenue
                Lafayette, LA  70506
*If paying by credit card, write "credit card" in
the "paid by" field and a customer service
representative will call you to process your
credit card information.

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