Easy MAIL or FAX ORDER FORM
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Sam Andy Authorized Dealer, P.O. Box 240, Aledo, Texas 76008
Toll Free: 1-888-855-8405 In Texas: 817-441-1165 Fax: 770-496-4305

Ship To:

Today's Date

Name

Address

City

State Zip

Phone

Fax Email
Qty. Item # Description Price Each Total Price
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Method of Payment:
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Name on Card_______________________________
Acct#______________________________________
Exp Date ______/______

Signature____________________________________		 Merchandise Total a
TX or CA sales Tax* a
Subtotal a
Pre-paid Shipping** a
TOTAL a
Please make checks payable to: Sam Andy Foods Authorized Dealer
* CA & TX residents add sales tax on non-food items only.
**Due to wide variation in weight, food items are shipped freight collect. If you prefer to prepay shipping on a food purchase, please call our toll free number for estimated charges