MARKUS LIFENET (UK.) LTD. INQUIRY FORM / ORDER FORM

UK phone: 01236 735588  UK fax: 01236735544 Intern.phone: +44 1236 735588 Intern.fax: +44 1236 735544

Email: info@markuslifenet.com    Internet web: www.markuslifenet.com

Please send me information on marked products by Mail____     Fax____   Email____
Contact name: __________________________________________________________
Company name: _________________________________________________________
Delivery address:_________________________________________________________
________________________________________________ Post code: _____________
Phone: ________________  Fax: __________________    Mobile:  ________________
Email: _________________________________   Internet web: ____________________
Date: ___/___/___         Inquiry ____          Order ____              Order no.: __________
Product no. Product name and description Quantity Price pr item Total pr product
1 150 010 MS.00 Hoisting Markusnet      
1 150 020  MS.00 Sailing Markusnet      
1 150 200  MS.02 Boating Markusnet      
1 151 000  MS.10 Lifting Markusnet (10 metre manual lifting height)      
1 152 000  MS.20 Lifting Markusnet (20 metre manual lifting height)      
1 153 000  MS.30 Lifting Markusnet (30 metre manual lifting height)      
1 154 000  MS.40 Lifting Markusnet (40 metre manual lifting height)      
1 210 025  RLC 25 Markus MOB Rescue line / Safety line      
1 310 270  SLB 6x270 Markus MOB Emergy Ladder      
1 340 185 SCN 6-185 Markus MOB Scramble net / Rolling net      
1 340 285  SCN 6-285 Markus MOB Scramble net / Rolling net      
1 340 335  SCN 6-335 Markus MOB Scramble net / Rolling net      
1 340 385  SCN 6-385 Markus MOB Scramble net / Rolling net      
1 350 185A  ROL 6-185 Markus MOB Boat Rescue net, SOLAS      
7 150 200  Markus glassfibre storage container with lid mounting bracket and container labels      
7 150 210  Markusnet PVC storage bag type standard white. Size in cm: L65xH40xW14      
         
Total Goods
Carriage Charge within UK, without VAT Carriage Charges
1st Class Post (Under 2 kg)         £ 6,00 Sub Total without VAT
3-Class Carrier (Under 15 kg)       £ 9,00 VAT
Pr. extra kg                                  £ 0,25 Total to be payed
Carriage Charges
I wish to pay by  Cheque, Visa, Mastercard, Switch, Delta.     (Please indicate by underline.)
Enclose a Cheque for £ __________
My Card No. is: __ __ __ __      __ __ __ __     __ __ __ __      __ __ __ __     __ __ __

Expiry Date ___ / ___      Switch issue no. ____________         Start Date ___/___/___