Aerial Specialists Inc. USA - Parts for Aerial Lifts

Aerial Specialists, Inc

Customer Order Form

Aerial Specialists, Inc.
The world leader in Aerial Lift OEM Parts!

"ASI-USA is the "Largest Listing" aerial lift parts supplier in the US, supporting over 75 manufactured lines of aerial lift equipment."

Secure Online Order Form

All fields are required.

BILL TO:		SHIP TO: Use Billing Information
* Company Name:		* Company Name:
* Contact Person:		* Contact Person:
* Address:		* Address:
* City, State, Zip:		* City, State, Zip:
* Country:		* Country:
* Phone Number:		* Phone Number:
* Fax Number:		* Fax Number:
* Email Address:

Equipment Information
Mfg Co:		Model:		Serial #:

Purchase Order Number
Purchase Order Number:

Quote Number - NOTE: If you received a quote via e-mail, please enter the Date & Time of email quote.
Quote Number:		*Date & Time:

Qty	Part Number	Description	Price Each	Total
			$	$
			$	$
			$	$
			$	$
			$	$
			$	$
			$	$
			$	$
			$	$
			$	$
			Parts Total:	$

Inbound and Outbound freight charges ARE NOT INCLUDED in the cost of the part. These charges will be added to your final invoice

Shipping Information
Ship Via Fed Ex:	Ground:	P-1:	2-Day:	3-Day:

Bill to my Credit Card:

Credit Card Information

* Complete Cardholder Name

as it appears on the card

* Complete Statement Address

Credit Card Type:

* Credit Card Number:

(No Dashes)

* Card Verification Number:

What's This?

Expiration Date:

Month: Year:

* I have read and agree to the return policy below.

THESE TERMS CANCEL AND SUPERSEDE ANY AND ALL TERMS OF SALE PREVIOUSLY ISSUED BY SELLER OR BUYER.

PERSONAL GUARANTEE: CARD HOLDER GUARANTEES PAYMENT OF ALL CHARGES PERTAINING TO THIS ORDER(S) AND AGREES TO PAY ATTORNEY’S FEES AND ALL COSTS FOR COLLECTION IN THE EVENT THEY DEFAULT ON THIS OBLIGATION.

INBOUND AND OUTBOUND FREIGHT/SHIPPING CHARGES ARE NOT INCLUDED IN THE COST OF THE PART. THESE CHARGES WILL BE ADDED TO THE FINAL INVOICE AND WILL BE BILLED TO THE CREDIT CARD PROVIDED.

ORDERS PLACED ARE ACKNOWLEDGED AS NON-CANCELABLE AND NON-RETURNABLE.

ANY RETURNS ALLOWED ARE UP TO THE DISCRETION OF ASI-USA PERSONNEL.

ALL RETURNS MUST BE IDENTIFIED BY AN ASI AUTHORIZED RGA NUMBER. CUSTOMER MUST CALL ASI TO OBTAIN SAID RGA NUMBER. ALL RETURNS MUST BE RECEIVED BY ASI BEFORE THE RGA EXPIRATION DATE. ALL RETURNS ARE SUBJECT TO INSPECTION AND CREDIT MAY BE DENIED IF THE ITEM DOES NOT MEET RETURN POLICY STIPULATIONS. ANY SHIPMENTS RETURNED FOR CREDIT OR EXCHANGE MAY BE SUBJECT TO A RESTOCKING CHARGE. IF AN ITEM IS RETURNED FOR EVALUATION, AND IT IS CONCLUDED THAT THE DAMAGE IS DUE TO CUSTOMER ACTION, NO CREDIT WILL BE ISSUED. ALL RETURNS MUST BE SHIPPED PREPAID AND INSURED.

Aerial Specialists, Inc - USA
1760 State Street • P.O. Box 085114 • Racine, WI 53408
(262) 632-0123 • Fax (262) 632-2458
parts@AerialSpecialists.com