Pre-pay for a quote

If you would like to pay for a purchase order, please provide the appropriate payment information below. You should have been provided with a Prepayment Quote number.

All fields are required.

Your Information Your Purchase Order Number Prepayment Quote # Total Order Amount Your name Company name Company web site Your email address

A confirmation email will be sent to this address. We do not use your email address for marketing purposes.

Your phone number

Credit card

(click to open a secure payment form hosted by Authorize.net, a VISA company)

Cardholder Billing Address Street Address
City State Zip

Confirmation

I authorize the above business to charge the credit card indicated in this authorization form according to the terms outlined above. This payment authorization is for the goods described above; or attached for the amount indicated above only, and is valid for one time use only. I certify that I am an authorized user of this credit card and that I will not dispute the payment with the credit card company; so long as the transaction corresponds to the terms indicated in this form. This transaction will appear as Premium Incentive Sales on your merchant statement.