PSE Logo Pacific Steam Equipment, Inc.
10648 Painter Avenue
Santa Fe Springs, CA 90670 		Phone: (562) 906-9292
Phone: (800) 321-4114
Fax: (562) 906-9223
Company:
Name:
Street:
City, State Zip:
Phone:
Fax:
 Please charge to my account with:
O MASTERCARD     O VISA    

Name of card holder (please print)
Card Number/ Expiration
Signature
Qty Stock No. Size Volt/Phase Description Unit Price Total
             
             
             
             
             
             
             
             
             
Upon completion of the order form, fax it to (562) 906-9223, or you may call in the information. We will promptly return the order form to you by fax or return call with prices and charges as requested. Subtotal    
Sales tax (if applicable)    
C.O.D. charges    
Freight & Handling    
TOTAL    

Thank You for your order.