Clement Technologies

 Remanufactured McManis™ Treatment Tables.

Designed for the discriminating physician specializing in physical medicine.

 

                   Order

   


Order Form for a McManis™ Table and McManis™ Accessories

(Only 20% Down Required)

          A 20% down payment is required at time of order placement. Any             remaining balance is payable in advance prior to shipping. Other             arrangements must be disclosed in writing in advance. Tables are shipped             freight collect.

   Purchaser's Name       
   Address
   City
   State
   Country
   Zip
   Phone (Office)
   Phone (Home/ Cell Phone)
   Ship to: (if different than above address)
   Name
   Address
   City
   State
   Country
   Zip
   Phone (Office)
   Phone (Home/ Cell Phone)
 
   Model of Purchase      Economy™    Vintage Deluxe™    Super Deluxe™                                                 Foot Pump Deluxe™
   Reconditioning Option      Partial      Full
   Base Price of the Model of Purchase
   Crating Charge $200.00 (only add if shipped Common Carrier)         Yes No
   Miscellaneous Options and Accessories
   Total Price of Miscellaneous Options and Accessories
   Total Price of Shipping and Handling Charge for Accessories (if order separate from table order,    add $10.00 multiplied by number of  items)
   Add $200.00 if your choice of vinyl color is not Colonial Blue (bluish gray)                                             Yes     No
 
   Idaho Residents Add 5% Sales Tax
   Total of Purchase
   Down payment
   Balance
   Upholstery (please choose what type of material)      Vinyl    Fabric                                                                                                                          Leather
   Indicate your choice of color if it is different from Colonial Blue

   

 
   

 

Clement Technologies

Phone:   +1-208-322-8840    E-mail:   mdclement2002@cableone.net

8255 Marcum Street, Boise, ID 83704, USA

  
                                    © 2004, Clement Technologies. All rights reserved.