ORDER FORM

2015_Product_Catalog

order form: u.s. addreses only TO ORDER BY PHONE: 1-800-786-4452 • Mon – Fri, 8 am – 7 pm CT TO ORDER BY FAX: 1-866-891-1695 TO ORDER BY MAIL: 25442 Network Pl., Chicago, IL 60673-1254 TO ORDER ONLINE: shop.iccsafe.org ICC Members: Provide your ICC member number to receive discount pricing _________________________________________________________ Date ________ /________ /________ CHECK IF YOU WOULD LIKE ADDITIONAL INFORMATION q Membership Application q Certification information q Product Catalog q Seminar information List Price, Member Price, Item Number Qty Each Each Description (specify edition) Total Shipping Rates Order Shipping Subtotal Charge U.S. Shipping, Continental 48 Up to $25, 10–15 day Media Mail . . . $4.50 Up to $25, 3–10 day FedEx Ground (no P.O. Boxes) . . . . . . . . . . . . . . . . . . . . $9 $25.01 to $50 . . . . . . . . . . . . . . . . . . . . . . $10 $50.01 to $100 . . . . . . . . . . . . . . . . . . . . . . $11 $100.01 to $200 . . . . . . . . . . . . . . . . . . . . $14 $200.01 to $500 . . . . . . . . . . . . . . . . . . . . $18 $500.01 and more . . . . . . . . 4% of subtotal AK, HI and U.S. Territories Shipping Up to $25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . $7 $25.01 to $200 . . . . . . . . . . . . . . . . . . . . . . $17 $200.01 to $500 . . . . . . . . . . . . . . . . . . . $30 $500.01 or more . . . . . . . . . . 8% of subtotal International Shipping Canada and Mexico . . . . . . 20% of subtotal All Other Countries . . . . $25+20% of subtotal International shipping rates may vary. Deliveries to remote areas may be delayed. Call for Express Delivery. PRICES SUBJECT TO CHANGE. Method of Payment: (Nonmembers of ICC must prepay by credit card, check or money order.) q Check or money order q Bill my Membership No. q Purchase Order No.: (COPY OF AUTHORIZED P.O. REQUIRED) q MasterCard q VISA q Discover q American Express CVV# (3- or 4-digit security code printed on card) Card No. ______________ /______________ /______________ /______________ Expires__________ /___________ Name as it appears on card: Signature (required) ICC USE ONLY All payments in U.S. Funds. Sales Tax: AK, AL, AR, AZ, CA, CO, CT, DC, FL, GA, HI, IA, ID, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, NC, ND, NE, NJ, NM, NV, NY, OH, OK, PA, RI, SC, SD, TN, TX, UT, VA,VT, WA, WI, WV and WY add applicable sales tax. Returns and Refunds Products may be returned in new, resalable condition within 30 days with proof of purchase. A restocking fee of 20 percent of the original selling price will be imposed on accepted returns. All returns must have written authorization from ICC. No refunds are made for software, audio or video products. Defective items may be exchanged only for the same titles or editions. Please call 1-800-786-4452 for complete details. Bill To: (Please Print) Person ordering ____________________________________________________________________________ Company or Jurisdiction ____________________________________________________________________________________________________ Attn: ______________________________________________________________________________________________________________ e-mail:_________________________________________________________________________________________________________________________________ Street __________________________________________________________________________________________________________________________________ City _____________________________________________________________________________________________________________________________________ State _________ Zip ____________________________ Daytime phone ( _________ )_____________________________________ Ship To: (If different from “Bill To” address or outside of U.S.) (Please Print) Company or Jurisdiction ____________________________________________________________________________________________________ Attn:_________________________________________________________________________________________________________________________________ Street __________________________________________________________________________________________________________________________________ City _____________________________________________________________________________________________________________ State _______________ Zip/Postal Code _________________________________________________________________________________________ 15-10950 07/15 Subtotal Shipping Sales Tax


2015_Product_Catalog
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