Clear Mountain Water: Order: New Customers: Order Form: Memphis Market

Step 2 - Choose your products. Two bottle minimum.

Code	Description	Price
1000	Water: Plastic Spring - 5 Gallon	$8.25
1005	Water: Plastic Distilled - 5 Gallon	$7.75
1050	CM Water: Clear Mountain - 5 Gallon	$7.35
1015	Water: Plastic Spring - 3 Gallon	$6.25
2000	CM Case Water: 12oz (24/case)	$8.95
2030	CM Case Water: 1.5L (12/case)	$8.95
2025	CM Case Water: 1L (12/case)	$8.00
2010	CM Case Water: 0.5L Sport Cap (24/case)	$8.95
2005	CM Case Water: 0.5L Flat Cap (24/case)	$8.95
2020	CM Case Water: 20oz Sport Cap (24/case)	$8.95
5000	Cups: Paper Cone Cups (Sleeve)	$3.25
5010	Cups: 12 oz.Paper Cups (Sleeve)	$3.95
8030	Crock: Crock & Stand (Rental every 4 weeks)	$5.00
8030	Cooler: Cook 'N Cold (Rental every 4 weeks)	$12.75
8030	Cooler: Hot 'N Cold (Rental every 4 weeks)	$14.75

$7.00 Bottle Deposit · One-Time $20.00 Processing Fee

Step 3 - Tell us how to reach you. (red fields are required)

	Deliver To
Name:
Address:
City:
State:	ZIP:
Phone:
Email:

	Bill To
Name:
Address:
City:
State:	ZIP:
Phone:
Email:

Number of people using the cooler?

Contact Person (if different from information above)
Name:
Phone:

Payment - Major Credit Card:
Visa
Mastercard
Other

Delivery Time:

Step 4 - Human Verification.

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Step 5 - Submit your order.

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Clear Mountain Spring Water · USA
(1-800) 467-1133 or 664-6700 · FAX (501) 664-8860
For questions or comments, please contact us.

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