All fields are required.

Name Of Company

Shipping Address


City

State

Zip Code

Telephone Number

Email Address

Contact Person (first and last name)

Purchase Order Number

Lamps must be ordered in multiples of 10 / Mixing lamp size is allowed

Terms Of This Order

All orders are subject to approval by BulbSource.
Terms are net 15 days.  Please make check payable to BulbSource.
Pay from invoice / no statement will be sent.
All payments are in U.S. funds only.
Buyer agrees to pay a late fee if buyer goes beyond terms of agreement ( up to18% per year).
Sales tax will be added to Oklahoma customers.
By printing full name in box below and submitting this order Buyer hereby agrees to all terms of this agreement.

Print Name In The Box Below.