DRC Distributors, Inc.

Please fill out form, print, and Fax to: 1-800-356-7698

DRC DISTRIBUTORS, INC.
7900 N. Radcliffe Street
Bristol, PA 19007

Toll Free Fax: 1-800-356-7698 For orders only
E-mail: DRCDIST@aol.com

Tools - Abrasives - Hobby Supplies
Surplus - Closeouts - Liquidations

Date:

SHIP TO Residential Commercial
(if other than Bill To:)

Bill To:

ATTN:

Phone:

FAX:

Your Order Number

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Shipping charges will be determined at the time the order is filled.

Credit Card No.

Expires

Picked By:_________________

Checked By:_________________

Packed By:_________________

Payable in US currency. All claims must be made within 5 days after receipt of merchandise.

Thank you for your order