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DI-100 Quote Request Form
Enter the following information to Get a Quote for the Heman DI-100:

Please wait for the confirmation page - it can take 30 seconds or so.

 denotes a required field

Quote Request form for HEDMAN DI-100
Cut Sheet Imprinter/Signer

Shipping Address and Contact Information
Name:  
  Title:  
  Organization:  
Address/ P.O. Box:  
City:  
State/Province:  
Zip/Postal code:  
Country:  
Phone Number:  
  Extension:  
  FAX:  
  E-mail:  

 

DI-100  Quantity

 

All orders ship UPS Ground and will be confirmed via Email or Telephone with the Total Order Amount 
including Shipping Charges (and  Sales Tax - CT, MA, ME, NY, NJ, RI, VT Residents only)

Billing Information

Purchase Order Number (optional)

Payment Method

Credit Card - Call Me for Credit Card Validation.
Check - Allow 10 days for Checks to clear.
Bill Me - Prior approval has been obtained.

Shipping Carrier

Federal Express
U.P.S. (Ground) Call for U.P.S Overnight or Second Day
DHL Worldwide Shipping
Other

Note: All Orders to Alaska and Hawaii
are shipped UPS Second Day.

Special Instructions:

Please follow the link to get Adobe Acrobat Reader 5.0 FREE Download and install if you dont already have it.
Then Click Here to Load the REQUIRED
DI-100 Signature Specimen Form and print it out.
Adobe Acrobat is required

Return the completed form to:

MAGEE COMPANY 
Attn: Kathy Derkin
41 West Street
Middlefield, Ct, 06455

Don't forget to submit your order after
printing out the form !!

Problems ? -  Click here to Track Your Shipment

Returned orders may be subject to a 25% re-stocking charge.