Please Print.............. ORDER FORM

Name_____________________________________________________________

Street Address:_____________________________________________________

City:_______________________________State:___________Zip:___________

Tel: Day_______________________________Eve_______________________________

Email Address:_________________________________________ We keep your addresses strictly confidential. We value your privacy as we value ours. No information is passed on to any entity.

Part #	Description	Qty	Item Price	Total
________	__________________________________________	_____	________	____________
________	__________________________________________	_____	________	____________
________	__________________________________________	_____	________	____________
________	__________________________________________	_____	________	____________
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			Subtotal
Add	CA Residents add 7.975% sales tax (.07975 of subtotal)		Sales Tax
Add	Shipping Charges (see below)		Shipping
	Make Checks Payable to Gaerlan Inc.		TOTAL
Mail to:	51056 Greenhill Rd Squaw Valley CA 93675	or FAX to (415) 677-8943		or CALL (559) 338-0600

Merchandise subtotal	Shipping charges
up to $19.99-	$7.95	If it is cheaper to ship using priority mail, we will do so and charge you this lower rate.
$20.00 to $69.99	$8.95	If you are sending a check, use the shipping rate on the
$70.00 to $99.99	$9.45	left. We will refund you any savings on shipping.
$100& over	$10.45
OVERSIZED	$16.95	Orders with oversized items like 26" , 700cc wheels, etc

For credit card orders only

___Visa ___Mastercard ........Expires _____month _______year 3 Digit Security Code (CVV)___ ___ ___ (look in theback of your card in the signature area - last 3 digits)

Card# __ __ __ __/__ __ __ __/__ __ __ __/__ __ __ __

State billing address if different from the above shipping address:

_____________________________________________________________________________

Orders shipped UPS/FEDEX ground. No PO box addresses for ground shipment. COD orders add $5.00 extra. International, Alaska and Hawaii orders shipped extra (call for rate). Orders shipped when check clears. If small orders like braze-ons can be shipped via postal mail, send UPS shipping rate and we will refund savings back to you. Orders to foreign countries shipped Postal mail insured. Call for exact rates. Returned checks will be subject to a $20 fee. Foreign buyers to be responsible for taxes, duties, brokerage fees that are assessed on their side. If fees are not paid and charged to us, buyer agrees to pay these delinquent fees plus a returned check fee. Warranty on framebuilding supplies stops once any product is subjected to any cutting, brazing, welding or modification. Any part that has been heated, brazed, cut or modified can no longer be returned.

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