Online Order Form
ONLINE ORDER FORM - For Chemicals and Supplies
       
Customer Name*: Contact:
Shipping Address*:
City, State, ZIP*: Phone #*:
Email Address*:
BIlling Address:
* = REQUIRED (Leave blank if same as Shipping Address)
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Current E-Z Flow Customer with open account
New Customer – please select desired payment method:
  COD Shipment
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      Card number:
      Expiration date:
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  I’d like to open an account (this may delay shipping 2-3 days):
Please send company credit information via FAX or E mail
Type of Foam In Place equipment currently in use:
Make: Model (if known):
Would you like a quote on Foam In Place equipment? Yes No
Type of foam chemicals currently used:
Manufacturer: Product #:
All prices are FOB San Diego, CA, and shipping will be prepaid and added to the order, unless otherwise arranged.
Type of shipping desired: Account #:
NOTE: 55 gallon chemical shipments require LTL Truck carrier.
15 gallon shipments can ship via Fed Ex.
Smaller shipments can ship Fed Ex or UPS.
If not specified, E-Z Flow normally ships via Fed Ex Ground.
I'd Like to Order the Following:
PRODUCT QUANTITY PRICE EACH
Universal, “A” (isocyanate), 55 gallon drum,
550 lbs @ $2.50/lb		 $1375.00
Universal, “B” (polyol), 55 gallon drum,
450 lbs @ $2.50/lb		 $1125.00
Botanithane, “A” (isocyanate), 55 gallon drum,
500 lbs @ $2.50/lb		 $1250.00
Botanithane, “B” (polyol), 55 gallon drum,
450 lbs @ $2.50/lb		 $1125.00
Universal, “A” (isocyanate), 15 gallon container,
150 lbs @ $3.00/lb		 $450.00
Universal, “B” (polyol), 15 gallon container,
130 lbs @ $3.00/lb		 $390.00
Botanithane, “A” (isocyanate),15 gallon container,
130 lbs @ $3.00/lb		 $390.00
Botanithane, “B” (polyol), 15 gallon container,
130 lbs @ $3.00/lb		 $390.00
Poly Film, silver, 36” unfolds to 72”,
1900 ft per roll		 $150.00
Poly Film, silver, 48” unfolds to 96”,
1425 ft per roll		 $150.00
Solvent, E-Z Solv, Gallon $75.00
Solvent, E-Z Solv, Quart $25.00
SLIDE Spray Solvent/Cleaner 16 oz can $15.00
Maintenance Pack
Contains (10) 2101 Cartridge O Ring
(6) 1013 Filter Screen
(6) 2122 Filter Nut O Ring
(1) Pkg Cart. Cleaners		 $25.00
Cartridge Rebuild Kit # CRK-040 $45.00
Valve Rebuild Kit # VRK
(One needed per valve; two for complete gun)		 $5.00
NOTE: Your order will be received and processed by E-Z Flow within one business day. We will calculate applicable shipping charges and sales tax, and will respond to you with a completed invoice for your order, prior to shipment. If we have any questions regarding your order, we will call you before shipment.

All orders will ship via UPS Ground, prepaid and added to invoice, unless otherwise noted or otherwise requested. We will be happy to use our Customer’s UPS or Fed Ex account, if provided.		  
For other parts or supplies needed, please contact E-Z Flow or call us at (858) 279-3569.
 
 
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