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Credit Card Type:   Please circle one                                                                          MC        VISA        AMEX       DISCOVER         

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Item No.

 

Description

 

Price

Qty Ordered

 

Total

30261B

Topaz Sig Gem 1x5

Pad w/tether, Gem Tools

Serial

195.00

 

 

Ship Via:   Please circle one               Ground,      3rd Day,     2nd Day,       Overnight

 *SHIPPING CHARGES WILL APPLY AND BE BILLED ACCORDINGLY.  SHIPPING CHARGES VARY DEPENDING ON THE ORDER.

 

PLEASE FAX OR EMAIL YOUR ORDER TO:   

     Computime Inc

     InsureVision Customer Offer

                 Tina Jeffcott     tina@ctstl.com

                 10772 Indian Head Ind Blvd

                     St. Louis, MO  63132

                     Tel:  800-423-8826 Ext. 1200