Frymate

Lions Restaurant Supplies FRYMATE LLC

10061 Riverside Dr Ste 564 1609 D1 Cross Keys Rd. #173
Toluca Lake CA 91602 Sicklerville, NJ 08081

1 833 593 5466 www.frymate.com

SALES/TRIAL/Order Form
1. Customer details:

Full name of the business _______________________________________________

Street address of business ________________________ City ______________
State __________ Zip code ____________ Restaurant Phone ____________
Mobile Phone __________________________ Fax _________________________
Email ________________________________ SALES REP __________________

2. Fryer details:

Brand of fryer 1 _____________________ Model # _____________ # of filters ____

Brand of fryer 2 _____________________ Model # _____________ # of filters ____
I ___________________________ of

hereby agree to purchase the above filter as discussed

Signed __________________Dated ________________ Authorised by_____________________

PRICE PER FILTER __________________ TOTAL PRICE QUOTED $_______________

Credit Card Number _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ZIP CODE _ _ _ _ _ _

Name on Card Expiry date _ _ / _ _ _ _ CVC _ _ _ _

3. New fryer measurements

All measurements must be made at the bottom of fryer where Frymate will be located.
Measurement indicators Size in millimetres (mm)
Left / Right measurement =
Front / Back measurement =
Handle depth =