National Environmental Services LLC - Order Form

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Enter Quantity desired.. then Click on "Calculate Results"

Item Quantity Price Each tax Amount
Green-Kit for Batteries 99.00 Each no $
Green-Kit for Ballasts 99.95 Each no $
Green-Kit for 4' Lamps 55.95 Each no. $
Green-Kit for U-Shape Lamps 44.95 Each no. $
Item Pending - -  $
Item Pending - -  $
Item Pending - -  $
Item Pending - - . $
Item Pending - -  $
Item Pending - -  $
Item Pending - -  $
    . .  

Shipping: N/C .

 $
TOTAL: $

The above amount is your total including shipping charges.


TAX APPLIES TO MN ORDERS ONLY

MN Tax:
$

MN TOTAL:
$

Billing address must be exactly as it appears on your credit card statement.
We can only ship to a street address - No Post Office Boxes Please.

BILLING ADDRESS SHIPPING ADDRESS 
 Check This Box If Same As Billing Address
name name
company company
address address
address line 2 address line 2
city city
state state
zip code zip code
phone phone
fax fax
email email

Payment Options

Pay by Credit Card 

 Card Card Number Expires

A representative may call or email you to verify information.

Pay by Check
Check orders take two weeks to process.

If by check, please print and mail this completed form and the total amount to:

National Environmental Services LLC
Post Office Box 390407
Minneapolis, MN 55439-0407

Call or fax your order:
800-872-2226 - toll free
952-830-1348 - phone

Existing Customers Only 
Purchase Order Number or Customer Code

Thank You For Your Order!
Please press "Submit Order" button only once to avoid double orders.
Clicking submit authorizes NES to process your order.