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B&W BRAKE - ORDER UP TO 10 AXLE SETS
OFF INVENTORY FORM

Hi!

If you have ordered from B & W Brake before; simply use your earlier documentation to complete the below form. Just enter the left and right B & W catalog caliper numbers you used last time, and the prices from last time, the part weight from last order (If available) and the current quantity of each item that you want directly into the form. If you only want one side, leave the other side blank. If you have special requirements, there is a comment area provided for you - right above the submit button below.

10 is the maximum number of different axles (sets) this form will allow you to place and order for at one time. Use this form as often as you like. The quantity of calipers per axle is unlimited. When you are done entering your numbers and calculations -- simply scroll down and click on the "Submit" button. This will generate and send an e-mail copy of your disc brake caliper order to B & W Marketing and send you an e-mail confirmation with your disc brake caliper order on it.

Thank you for using our semi-automated order off inventory form. Hope this 24/7 B & W service saves you time and money.




www.BandWBrake.com


Please enter your B & W Customer Number If Known:

Please enter your full name (required):
Please enter your Company's name (required):
Please enter your e-mail address (required): (This does not work without your correct address.
Please enter your contact phone number (required):
Please enter your Fax number:
Please enter your shipping street address or P.O.Box number (required):
Please enter your second shipping street address or P.O.Box number (If any):
Please enter your city (required):
Please enter your state (required):
Please enter your zip code (required):
Please -- if applicable -- enter your purchase order number or tracking number:
Billing address (If different from shipping address above.):


Caliper Pair (Axle) No.1:

Left/Driver Side B&W Part Number From Last Order:
How many left/driver side?
Right/Passenger Side B&W Part Number From Last Order:
How many right/passenger side?
Disc Brake Caliper Core Cost Each (If Applicable):
B & W Part Price Each
Shipping Weight In Pounds For Each Part Ordered (If known):
YOUR Total Calculated Part's Shipping Weight In Pounds For This Axle (If known):
YOUR Total Calculated Price For This Axle:


Caliper Pair (Axle) No.2:

Left/Driver Side B&W Part Number From Last Order:
How many left/driver side?
Right/Passenger Side B&W Part Number From Last Order:
How many right/passenger side?
Disc Brake Caliper Core Cost Each (If Applicable):
B & W Part Price Each
Shipping Weight In Pounds For Each Part Ordered (If known):
YOUR Total Calculated Part's Shipping Weight In Pounds For This Axle (If known):
YOUR Total Calculated Price For This Axle:


Caliper Pair (Axle) No.3:

Left/Driver Side B&W Part Number From Last Order:
How many left/driver side?
Right/Passenger Side B&W Part Number From Last Order:
How many right/passenger side?
Disc Brake Caliper Core Cost Each (If Applicable):
B & W Part Price Each
Shipping Weight In Pounds For Each Part Ordered (If known):
YOUR Total Calculated Part's Shipping Weight In Pounds For This Axle (If known):
YOUR Total Calculated Price For This Axle:


Caliper Pair (Axle) No.4:

Left/Driver Side B&W Part Number From Last Order:
How many left/driver side?
Right/Passenger Side B&W Part Number From Last Order:
How many right/passenger side?
Disc Brake Caliper Core Cost Each (If Applicable):
B & W Part Price Each
Shipping Weight In Pounds For Each Part Ordered (If known):
YOUR Total Calculated Part's Shipping Weight In Pounds For This Axle (If known):
YOUR Total Calculated Price For This Axle:


Caliper Pair (Axle) No.5:

Left/Driver Side B&W Part Number From Last Order:
How many left/driver side?
Right/Passenger Side B&W Part Number From Last Order:
How many right/passenger side?
Disc Brake Caliper Core Cost Each (If Applicable):
B & W Part Price Each
Shipping Weight In Pounds For Each Part Ordered (If known):
YOUR Total Calculated Part's Shipping Weight In Pounds For This Axle (If known):
YOUR Total Calculated Price For This Axle:


Caliper Pair (Axle) No.6:

Left/Driver Side B&W Part Number From Last Order:
How many left/driver side?
Right/Passenger Side B&W Part Number From Last Order:
How many right/passenger side?

Disc Brake Caliper Core Cost Each (If Applicable):
B & W Part Price Each
Shipping Weight In Pounds For Each Part Ordered (If known):
YOUR Total Calculated Part's Shipping Weight In Pounds For This Axle (If known):
YOUR Total Calculated Price For This Axle:


Caliper Pair (Axle) No.7:

Left/Driver Side B&W Part Number From Last Order:
How many left/driver side?
Right/Passenger Side B&W Part Number From Last Order:
How many right/passenger side?
Disc Brake Caliper Core Cost Each (If Applicable):
B & W Part Price Each
Shipping Weight In Pounds For Each Part Ordered (If known):
YOUR Total Calculated Part's Shipping Weight In Pounds For This Axle (If known):
YOUR Total Calculated Price For This Axle:


Caliper Pair (Axle) No.8:

Left/Driver Side B&W Part Number From Last Order:
How many left/driver side?
Right/Passenger Side B&W Part Number From Last Order:
How many right/passenger side?
Disc Brake Caliper Core Cost Each (If Applicable):
B & W Part Price Each
Shipping Weight In Pounds For Each Part Ordered (If known):
YOUR Total Calculated Part's Shipping Weight In Pounds For This Axle (If known):
YOUR Total Calculated Price For This Axle:


Caliper Pair (Axle) No.9:

Left/Driver Side B&W Part Number From Last Order:
How many left/driver side?
Right/Passenger Side B&W Part Number From Last Order:
How many right/passenger side?
Disc Brake Caliper Core Cost Each (If Applicable):
B & W Part Price Each
Shipping Weight In Pounds For Each Part Ordered (If known):
YOUR Total Calculated Part's Shipping Weight In Pounds For This Axle (If known):
YOUR Total Calculated Price For This Axle:


Caliper Pair (Axle) No.10:

Left/Driver Side B&W Part Number From Last Order:
How many left/driver side?
Right/Passenger Side B&W Part Number From Last Order:
How many right/passenger side?
Disc Brake Caliper Core Cost Each (If Applicable):
B & W Part Price Each
Shipping Weight In Pounds For Each Part Ordered (If known):
YOUR Total Calculated Part's Shipping Weight In Pounds For This Axle (If known):
YOUR Total Calculated Price For This Axle:


ORDER TOTALS


YOUR Total Calculated Part's Shipping Weight In Pounds For This Order (If known):
YOUR Total Calculated Shipping Cost For This Order (If known):
YOUR Total Calculated Price For This Order:



If you have any special requirements - please enter them here:


Copyright 2004 Cecil R. Taylor

Copyright 2004,2005 Cecil R. Taylor

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