Damzac Corporation 

                           1-800-940-ROLL (7655)

     Contact Us

Damzac Corporation

Mail To:  P.O. Box 1642,   Elfers,  FL  34680-1642

Fax: 727-372-9471    or   Phone: 1-800-940-ROLL (7655)

ORDER FORM

Please send payment with your order.

You may telephone or fax order with credit card information. 

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Thank you!

Contact Information

Name
Title
Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
FAX

Please provide the following ordering information:

QTY	Description	Price
	Grand Total

 

Description	SKU #	Price/each
Rubber Roller - 50 x 113mm	COD134	$19.35
Rubber Roller - 30x 80mm	3080	$19.35
Single Belt	DAM	$50.00

 

	BILLING
Credit Card
Cardholder Name
Card Number
Expiration Date

	SHIPPING
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country

"Keep on Rollin"

and...

Thank you for your continued business!