Customer Information
Order Date:
Ordered By:
Phone:	Ext:
Customer ID:
Customer PO#:
Billing Information
Company Name:
Address:
Address:
City:
State:	AKALARAZCACOCTDCDEFLGAHIIAIDILINKSKYLAMAMDMEMIMNMOMSMTNCNDNENHNJNMNVNYOHOKORPARISCSDTNTXUTVAVTWAWIWVWY
Zip:
New Customer:	Yes No
New customers must fax/e-mail resale certificate to 877-547-8675 / jdelrosso@gosalt.com or tax will not be refunded to orders for NY, NJ and PA
Package Deliveries Full Truckloads (T/L) are 16-20 pallets Half Truckloads (1/2 T/L) are 8-10 pallets Less Than Truckloads (LTL) are 1-7 pallets Bulk Dry Material NY min 35 tons All other states min 25 tons Liquid Material Full T/L 4,500 gallons Half T/L 2,500 gallons (Minimum order 2,500 gallons)

Design by Computer and Financial Associates Inc.