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Order No.: Date: Consignment Delivery Date: Customer Information Company Name (In Full): Contact Info Address: Town: Postal Code: Tel no.: Fax no.: Contact: Address: Town: Postal Code: Tel no.: Fax no.: Contact: Delivery Point Company Name (In Full): Contact Info Comments or Special instructions if any 1 of 3 IP Interplast UK Order Form www.interplast.co.uk Item Part No / Code Description Unit Qty Price/unit Total 1 £ £ 2 £ £ 3 £ £ 4 £ £ 5 £ £ 6 £ £ 7 £ £ 8 £ £ 9 £ £ 10 £ £ 11 £ £ 12 £ £ 13 £ £ 14 £ £ 15 £ £ 16 £ £ 17 £ £ 18 £ £ 19 £ £ 20 £ £ 21 £ £ 22 £ £ 23 £ £ 24 £ £ 25 £ £ 26 £ £ 27 £ £ 28 £ £ 29 £ £ 30 £ £ Total without VAT. 2 of 3 £ IP Interplast UK Order Form www.interplast.co.uk Notes: 1. All orders are subject to our Standard Terms and Conditions of Sale. 2. All prices are net exclusive of VAT which will be charged at the rate prevailing on date of dispatch. 3. For next day delivery, orders must be received and accepted by 12 am (noon). Full Signature: Full name: 3 of 3 Date/Month/Year IP Interplast UK Order Form www.interplast.co.uk