Double-Cola and Ski Products
ORDER FORM

Please print this order form and mail it with a check or money order to:
Double-Cola Co. - USA Products
537 Market Street, Suite 100
Chattanooga, TN 37402

Visit our Company Store for branded merchandise.

Description Quantity Price Quantity of Cases Total
Double-Cola case
of 12 oz. cans		 24 Cans 8.00 _____ _____
Diet Double-Cola case
of 12 oz. cans		 24 Cans 8.00 _____ _____
Ski case of 12
oz. cans		 24 Cans 8.00 _____ _____
Diet Ski case
of 12 oz. cans		 24 Cans 8.00 _____ _____
Cherry Ski case
of 12 oz. cans		 24 Cans 8.00 _____ _____
Shipping (see rates below)  _____
Handling 5.00
TN Residents add 8.25% _____
TOTAL CHECK _____

Ship To:

Name______________________________________________________________
Address____________________________________________________________
City______________________ State______________ Zip___________________
Phone____________________ E-mail___________________________________

Please allow 2 weeks for delivery. No cash please. Offer good for a limited time only.
Void where prohibited or restricted by law. Shipments to the United States only.


Shipping Zone Rates

Zones

Green

Yellow

Pink

Blue

Orange

per case

$9.73

$9.73

$9.73

$10.49

$12.12

Green: ME, NH, MA, RI, CT, NY, PA, DE, MD, VA, WV, OH, SC
Yellow: MI, IN, KY, GA, FL, AL, TN, IL, WI
Pink: MN, IA, MO, AR, LA, KS, MS
Blue: ND, SD, NE, CO, OK, TX
Orange: MT, ID, UT, AZ, NV, CA, OR, WA, WY, NM

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