10% Discount Order Form
Ship to: (We must verify and ship to the billing address for your credit card.)
Name 
Street  Apt # 
City  State  Zip 
Home Phone (        )
Work Phone (        )
Email 
 
Mercedes Information
Year  Model 
Chassis #  Engine # 
Shipping Information
When paying by credit card UPS shipping will be added to your total. When prepaying by check please call for a shipping quote. All parts to large or heavy for UPS will be shipped by a truck line, freight collect.
 
  Qty   Part #   Description   Price ea   Total
         
         
         
         
         
         
         
         
         
         
         
      10% Discount for Fax or Mail-in Orders    
      Shipping (see shipping info above)    
 Payment
 Method:
  Money
Enclosed 		    
Total  
 
 Card #  Exp. Date 
 Signature 
  I have read and agree to company policy below.
Fax to:
1-765-286-4184
or Mail to:
Adsit Company Inc
12440 South Old Rd.
Muncie, IN 47302
 
WARRANTY:
Absolutely no refunds or returns.
Our warranty is for 30 days on an exchange basis only.
All sales are final.
DAMAGED PARTS: All parts leave our warehouse in good condition. If a part is received damaged, immediately call the shipping company to file a claim. Damaged parts are warranted on an exchange basis only, absolutely no refunds.
SHIPPING CHARGES: All shipping charges are the customers responsibility. We do not pay any shipping charges. I authorize Adsit Company to charge my credit card for any and all shipping charges, including call tag requests.
AGREEMENT ON JURISDICTION TO DAMAGES: Adsit Company Inc. and Customers agree that any suit, claim or legal proceedings of any nature between the parties must be filed and prosecuted in Delaware County Indiana and shall be controlled by the laws of the State of Indiana then in effect. Adsit Company Inc. warrants that all parts are in good condition and working order. Any parts that are defective will be replaced. That Adsit Company Inc. liability shall be limited to the original price of the goods and that Adsit Company shall not be responsible for exemplarily, punitive or consequential damages or laber charges. In the event that the buyer fails to pay as agreed, the buyer agrees to pay all attorney fees, court cost, expenses and interest incurred by Adsit Company in the collection of all sums.