14000 W. 215th St., Bucyrus, KS 66013-9519

Ph. 913-879-2587 - 7:30 A. M. - 3 P. M  CST  Monday-Friday

24-hour Fax.  913-533-2497 

Minimum order $10.00 

Contact us by email any time.

Smith Poultry & Game Bird Supply

 

Name __________________________________________________ Date _____________

 

Address_________________________________________ (UPS requires a physical address)

 

City, State, & Zip Code______________________________________________________

 

 Ph. #____________________    E-mail ________________________________________

 

Quantity

Name of Item Being ordered

Unit Price

Total Price

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

                                                       Sub-total

 

 

 

Shipping Charges (call or e-mail us)

 

 

 

Sales Tax (Kansas residents only)

 

 

 

**Insurance

 

 

 

Order Total

 

 

 

Method of Payment

 

 _________Check or Money order     Discover, Master Card, Visa  (Circle Card Company)

 

  Card  #__________________________________________ Exp. Date:  _____________

 

  3 digit # from back of card _________________________________________________

 

 Card billing address _______________________________________________________

 

 _______________________________________________________________________

(signature of Credit Card Holder)

 

**Insurance is included in UPS rates for shipments valued up to $100.00.  Add $2.70 if the shipment’s value is between $101.00 and $300.00.  After that insurance is $.90 per $100.00.

Prices for Priority Mail valued up to $50.00 include insurance.  Call for insurance if the order is  $50.01 and over.