| Mail to |
| DAN'S RESIN CASTING |
| 108 Clarence St. |
| Allegany, NY 14706-1103 |
| SOLD TO | |||
| NAME | |||
| ADDRESS | |||
| CITY | STATE | ZIP | |
| Qty. | Item Number | Description | Item Price | Total Price |
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Merchandise total |
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| New York State add 8% (.08 )Tax | ||||
| Shipping | ||||
| Insurance | ||||
| Total | ||||
Please see information page for insurance and shipping rates
Please make checks out to: Dan Pikulski or Dan's Resin Casting