Bestellformular für die - M-Base

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Bestellformular für die - M-Base
M-Base Engineering + Software GmbH
Dennewartstr. 27 • 52068 Aachen • Germany
Fax: +49-241-963-1469 • E-mail: [email protected]
Order/Bestellung
Chemical Resistance of Plastics and Elastomers
Number/ Product/Produkt
Anzahl
Price/
Preis
Addition/
Summe
€ 490,00
€
VAT/
19% MwSt.
€
Total/
Endsumme
€
Access to Chemical Resistance Database (12 months)
Zugang zu Chemical Resistance Database (12 Monate)
o Please extend automatically after one year for another 12 months/
Bitte um automatische Verlängerung um jeweils ein Jahr nach Ablauf
o We want to pay via invoice/
Wir möchten per Rechnung zahlen
o We want to pay with Credit Card/
Wir möchten mit Kreditkarte zahlen
o VISA Card*
o Master Card*
Name:
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Company/Firma:
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Address/Adresse:
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Phone/Telefon:
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Telefax:
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E-mail:
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for EU customers VAT number:/
für EU Kunden UST.-IdNr.:
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Date/Datum:
Signature/Unterschrift:
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*Credit Card/Kreditkarte
Credit card holder/Kreditkarteninhaber:
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Credit card number/Kreditkartennummer:
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Valid thru/Gültig bis:
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CVC Card Validation Code/3-stellige KPN:
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Date/Datum:
Signature/Unterschrift:
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