Product specifications

ZYGO-USA Toll Free: [phone]
www.zygo-usa.com 48834 Kato Road, #101-A, Fremont, CA 94538 Tel: [phone]
[e-mail] Fax: [phone]
ORDER FORM and
Rental Agreement Date (mm/dd/yy): ______________
Quantity
Item Number
Description
Rental Period
(in weeks)
Unit Price or
Weekly Rental Price
Amount
Subtotal
$
* Tax:
Sales tax will be added for shipments to some areas.
Call Customer Service for tax rate or amount.
Applicable Tax*
$
Freight (S&H):
We will ship by 2- or 3-day delivery methods if possible.
Freight (S/H)
$
Call Customer Service with any questions.
ORDER TOTAL
$
Call [phone] Target date for product delivery: _____/_____/_____
BILL TO:
SHIP TO: (we cannot ship to P.O. Box)
Name
Name
Facility
Facility
Dept
Dept
Address
Address
City / ST / ZIP
City / ST / ZIP
Phone Number
Phone Number
E-mail
E-mail
Payments in the form of check, money order, credit card, and purchase order are acceptable.
 Check or money order enclosed in the amount of $______________________________, payable to ZYGO-USA
 Visa
 Master Card
 American Express
 Discover
By my signature below I acknowledge that I have read, understand, and agree
to the Terms and Conditions of ZYGO’s Order Processing and Shipping Policies.
AUTHORIZED SIGNATURE________________________________________________________________ Date _____/_____/_____
Customer’s signature is required for acceptance of agreement terms
PRICES ARE IN U.S. DOLLARS. PRODUCT SPECIFICATIONS AND PRICES ARE SUBJECT TO CHANGE WTIHOUT NOTICE.