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Quick Order Pad

Maybe it's after hours and you'd like to place a quick order?

Simply fill in this Quick Order Pad and we'll confirm your order immediately the next business day.

Pacific Industrial Supply
(714) 540-7122 •  (323) 727-5001 • (858) 277-8550 • Fax: (714) 540-4054
sales@pacificindustrialsupply.com

Name:
Company:
Phone:
Fax:
Email:
   
Your Purchase
Order Number:
   
Ship to address:
Address (cont.):
City:
State:
Zip:
   
Quantity Description Unit Cost Extended
Cost
    TOTAL:

Shipping:

credit cards accepted
Credit cards can be used for your purchases, or enter your PO number on the Quick Order Pad.

Need to open an account? Click here.


 
 
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Contact us by phone: (714) 540-7122 or (323) 727-5001