Price Quotation / Order Form   Affordable Lighting.com   A Division of Complete Lighting, Inc.   2755 Etherkee Dr., SE   Bessemer, AL 35022   Toll Free Phone: 1-800-683-8825   Toll Free Fax: 1-888-683-8825   E-mail: info@affordablelighting.com   Web Site: affordablelighting.com Date: _____________________    PO / Quote # _____________________    Phone # _____________________    Fax # _____________________    Email:  _______________________________________    Bill To: _____________________________ _____________________________ _____________________________ Contact: ______________________________   Ship To: ______________________________ ______________________________ ______________________________ Ship Via: ______________________________ Qty. Part# Description Price Amount                                                                                           Visa__   Master Card__   Discover__   American Express__ MERCHANDISE TOTAL      Card # |__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__| SHIPPING & HANDLING      Exp Date: |__|__|__|__| APPLICABLE SALES TAX      Signature: _________________________________ ORDER TOTAL