ORDER FORM: INTERNATIONAL ADDRESS ONLY

2016 Product Catalog

order form: international addreses only TO ORDER BY PHONE: 001-708-799-2300, x33801, Mon–Fri, 8 a.m.–7 p.m. CT TO ORDER BY FAX: 001-708-799-4981 TO ORDER BY MAIL: 25442 Network Pl., Chicago, IL 60673-1254, USA TO ORDER ONLINE: shop.iccsafe.org All International Orders must be prepaid in U.S. Funds drawn on a U.S. Bank. We gladly accept payment by MasterCard, Visa, American Express, Discover, JCB or a check/money order denominated in U.S. dollars and drawn on a U.S. bank. All prices are quoted in U.S. dollars. Date ______ /______ /______ Ship To: (Please Print) Person ordering __________________________________________________________________ Company or Jurisdiction _____________________________________________________________________________________ Attn: _____________________________________________________________________________________________ Street ______________________________________________________________________________________________________ City _______________________________________________________________________________________________________ State/Province_________________________________________________________ Postal Code _______________________ Country ________________________________________ Daytime Phone___________________________________________ E-mail_____________________________________________________________________________________________________ Item Number Qty List Price, Each Member Price, Each Description (specify edition) Total SUBTOTAL SHIPPING TOTAL PAYMENT Method of Payment: (Nonmembers of ICC must prepay by credit card, check or money order.)  Check or money order  Bill my Membership No.  Purchase Order No.: (COPY OF AUTHORIZED P.O. REQUIRED)  MasterCard  VISA  Discover  American Express CVV# (3- or 4-digit security code printed on card) Card No. _________ /_________ /_________ /_________ Expires_________ /_________ Name as it appears on card: Signature (required) ICC USE ONLY CHECK IF YOU WOULD LIKE ADDITIONAL INFORMATION  Membership Application  Certification information  Product Catalog  Seminar information International Shipping Standard: Canada and Mexico....................20% of subtotal All Other Countries.............$25+20% of subtotal Call for Express Delivery Billed:  FedEx Acct. #______________________ Deliveries to remote areas may be delayed. All payments in U.S. Funds. *Wire Transfers Add $25 (U.S.) for bank fees. Wire to: JP Morgan Chase Bank, N.A. ABA 0210-00021 Acct. #935163733 SWIFT Code: CHASUS33 Date funds sent: ______ /______ /______ Please send email notification of transfer to: collections@iccsafe.org Thank you for your order! ICC Members: Provide your member number to receive discount pricing ________________________________________ 16-12353 07/16 PRICES SUBJECT TO CHANGE.


2016 Product Catalog
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