OLD CHICAGO RESTAURANTS

ONLINE ORDER FORM

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Product Name Quantity X Unit Price = Totals
Aerosol Air Freshener Cabinet X $37 =
Gel Cup Air Freshener Cabinet X $18 =
Aerosol Refill Cans (case of 12) X $69 =
Gel Cup Refills (case of 12) X $27 =
Urinal Screen with Para Block (case of 12) X $22 =
Select Plus (Gallon) X $12.50 =
Select Plus (Case) X $37.50 =
Alpha 3 (Gallon) X $14.75 =
Alpha 3 (Case) X $52.90 =
Thermo Clean (Gallon) X $8.50 =
Thermo Clean (Case) X $32 =
HydroFoamer Foam Gun X $59 =
20" Floor Pads-white, natural, red, black
(5 pads/case)		 X $30.60 =
Product Total
*Sales tax charged only in Colorado
*Shipping charges will be added