By placing an order with SPi, SPi's associates or agents, the purchaser agrees to be in full compliance with the terms listed herein and obey all local, state, federal, and international laws. Purchaser assumes all responsibility for his / her actions.
I do hereby verify that I have fully read and understand this statement and agree to it's terms
COMPANY NAME:_____________________________________________
PURCHASERS NAME:__________________________________________
ADDRESS:___________________________________________________
STATE, ZIP, COUNTRY:_________________________________________
DATE:_______________________________________________________
PHONE/FAX #:________________________________________________
PURCHASERS NAME PRINTED:__________________________________
ITEM(s) PURCHASED:__________________________________________
SIGNATURE:_________________________________________________
Please read this document, complete all questions, sign and fax to (805) 772-3557
SA-5.5.99,df/SPI doc # 2789323.K