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CoastlineCover@earthlink.net Back to Main Page Order by phone 1-800-216-1664
     

Coastline Cover Company Order Form
10096 Sixth Street
Rancho Cucamonga, CA 91730
909.484.6592 — 800.216.1664 — FAX 909.484.6001

Billing Address Shipping Address
First Name First Name
Last Name Last Name
Address 1 Address 1
Address 2 Address 2
City City
State State
Zip Zip
Country Country
Phone Phone
Alternate Phone Alternate Phone
E-mail address E-mail address
Items Purchased
Item Size / Color VEHICLE

Qty

Unit Price

 Total Price
Year Make Model
Tow Car Shield  $340.00
Mirror Covers, Pr, Tow Car $20.00
Ultimate Car Cooler $105.00
Coach Mask & Twist Locks  $460.00
Mirror Covers, Pr, Motor Home $45.00
Mesh Window Cover  $265.00
Tire Sun Guards, pair     
Bicycle Bag      
Vinyl Protector $10.95
Vinyl Cleaner $11.75
  Subtotal:

 

   CA Sales Tax:

  Grand Total:

Note: Shipping and handling will be calculated and added later. You will receive an invoice with the total amount, including shipping charge, in the mail. Shipping and handling are non-refundable charges.

Sales Tax will be added to all California orders


Payment Information
VISA Credit Card Number
MasterCard Expiration Date
Discover Name of cardholder
 
 
Shipping Information

Call for availability if rush delivery is required. Most of our products are made to order and may experience seasonally delayed shipping.
 
 
Additional Information

Enter any additional information or specific directions below:

 

 

— Sales Tax will be added to all California orders —

SHIPPING COSTS ARE NON-REFUNDABLE
ALL PRICES ARE SUBJECT TO CHANGE

Coastline Cover Company
10096 Sixth Street, Rancho Cucamonga, CA 91730
1-800-216-1664
Email: CoastlineCover@earthlink.net
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