ORDER CONFIRMATION

New Equipment / Repairs / Spares
To confirm your order please fill in all of the relevant details below (Please remember to fill in all important information marked with an asterisk* otherwise we will not be able to accept your e-mail)
Please use this form as confirmation of Order and accepting the terms of business as presented by Safelite Ltd.,which will be as stipulated on your quotation. Only confirm your order if you accept our terms of business as presented.
Our Quotation Ref*
Your Order Ref*
Value of Order*
(Pounds Sterling)
Authorised By*
Authorising Department*
Delivery Date*
(to be confirmed)
Name*
Company*
Depot
Position
Telephone*
Fax
E-mail*
Address 1*
Address 2*
Town/City*
County/State*
Post/Zip Code*