Data Tranz LLC
Data Systems for Business
PO Box 605 Valley City, ND 58072
Phone 888-488-8726	FAX ORDER

GlassShop Deluxe	

Fax toll free to:
1-800-316-5829	1.	Enter System,  number of workstations and site licenses in the Quantity and carry over to the Total Column.
2.	Add optional Prepaid Service & Support otherwise your card will be billed monthly along with applicable EDI charges.
3.	Total your order.
4.	Fill out credit card information.
5.	Fax form to: 1- 800-316-5829	

Quantity	Unit Price	DESCRIPTION	TOTAL	
	$299.99	GlassShop Deluxe		
	50.00	NAGS Site license (1 minimum)		
	225.00	NAGS Workstation License (1 minimum)		
	420.00	1 year Prepaid Service and Support charges (optional)			
	Subtotal		
	Sales Tax (ND Residents add 6%)		
	Priority Mail & Handling	10.00	
	TOTAL		

Company Name_____________________________________________
Owner ____________________________________________
Address ___________________________________________
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	Credit Card Information

Circle:   Visa / MasterCard / American Express  

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Exp Date:                                                             . 

Authorized by___________________________________                                                                                 

Date__________________________________________

	
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