FLINT RIVER RANCH Super Premium Health Food for Pets
ORDER FORM Please Print Legibly (Reorders add Assigned FRR#)
FLINT RIVER RANCH
1243 Columbia Avenue,B-6
Name: ______________________FRR#_____ Riverside, CA 92507-2123
Addr:____________________________ 909-682-5048
____________________________ FAX:(Orders)909-682-5057
City:____________________________
State: ____ Zip: ___________ Distributor ID 1483
Phone: (________) __________ Larry A. Bernstein, VMD
Date: ________ 751 NE 168 Street
N. Miami Beach,FL 33162
305-652-5372
PAYMENT BY: Check __ Visa __ M/C __ Optima __ AmExp __ EFT ___
Card# _ _ _ _ - _ _ _ _ - _ _ _ _ - _ _ _ _ Expires: _______
Cardholder Signature: ______________________________________
Code ALL SUPER PREMIUM Quant Total
DOG40 40 lb. KIBBLE Puppy & Adult $45.75 _____ ______
DOG20 20 lb. KIBBLE Puppy & Adult $24.25 _____ ______
DOG6 6 lb. KIBBLE Puppy & Adult $ 9.70 _____ ______
NUG40 40 lb. Nugget Size Dog $45.75 _____ ______
NUG20 20 lb. Nugget Size Dog $24.25 _____ ______
SEN40 40 lb. SENIOR Kibble Dog $45.75 _____ ______
SEN20 20 lb. SENIOR Kibble Dog $24.25 _____ ______
BON20 20 lb. Dog Bone Treat $35.00 _____ ______
*BON4 4 lb. Dog Bone Treat $ 9.95 _____ ______
*TREAT 12 oz Cat/Kitten Treat $ 4.58 _____ ______
CAT20 20 lb. Cat/Kitten Food $39.98 _____ ______
CAT6 6 lb. Cat/Kitten Food $13.50 _____ ______
TRE8 8 lb. Cat/Kitten Treat $33.00 _____ ______
TOTAL ORDER AMOUNT $__________
*NOTE**
** A 40 lb. Package is (2) 20 lb., bags.
** NUGGET Size is ¼ X 5/8 inch shape.
** EFT - Check Payment is accepted by TELEPHONE or FAX.
** Order canceled if Credit Card payment declined or invalid. Notification sent by mail.
** CHECK ___(YES) for us to advise if Credit Card not Valid. ($5.00 Fee is Charged)
** INSUFFICIENT FUND Check $15 Fee Charge,
** Dog Bone or Cat Treats shipped seperate - add $3.50 Not extra when shipped with an order.
AUTHORIZATION FOR AUTOMATIC SHIPMENT: I hereby authorize FLINT RIVER RANCH to automatically deliver
or ship prepaid, the following product order and request FLINT RIVER RANCH initiate debit entries to my credit card or
EFT account to effect any payment owing by me to FLINT RIVER RANCH. I understand that to cancel this authorization
require a MINIMUM OF 5 BUSINESS DAYS WRITTEN NOTICE to FLINT RIVER RANCH.
CODE ____ AMOUNT _______ SHIP EVERY: 3 Weeks ___ Month ___ Other ___
CODE ____ AMOUNT _______ SHIP EVERY: 3 Weeks ___ Month ___ Other ___
Date: _______________ Cardholder Signature: __________________________________________
100% PRODUCT SATISFACTION GUARANTEED OR RETURN PREPAID UNUSED PRODUC WITHIN 30 DAYS OF PURCHASE FOR FULL PURCHASE REFUND. PRICE INCLUDES DELIVERY.
PRICE INCLUDES DELIVERY.
ESTIMATED DELIVERY TIME:
W.Coast: 3-5 bus. days. Central: 5-8 bus. days. East/S.E:. 7-10 business days. (10/96)
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