2026 KPMI Full Catalog V1 - Flipbook - Page 368
KPMI PRODUCT ORDER FORM
®
KIBBLEWHITE PRECISION MACHINING, INC
Office / Billing: 4320 Coast Hwy 1 ~ Pacifica, CA 94044 Shipping / Receiving: 371 Princeton Ave ~ Half Moon Bay, CA 94019
Machine Shop: 580-H Crespi Dr ~ Pacifica, CA 94044
Web: www.kpmi.us
Phone : (650) 557-2046
ORDER FORM
UPS
DATE: ___________________
BY: __________________
CUST #: _________________
P.O. #: _______________
FEDEX
USPS
RED - 1 Day
RED - 1 Day
AIR
BLUE - 2 Day
BLUE - 2 Day
PRIORITY
ORANGE - 3 Day
SAVER - 3 Day
EXPRESS
GROUND
BILL TO: ________________________________________
SHIP TO: ________________________________________
CONTACT NAME: _________________________________
WEIGHT: _____________
CREDIT CARD
WILL CALL
COD
STREET: ________________________________________
SHIP CHRG $: _____________
INS $: _____________
OPEN ACCT.
COD $: _____________
CITY: ___________________________________________
ZIP CODE: ____________
TELEPHONE: ___________________
ITEM #
QTY
ORDERED
MISC $: _____________
COUNTRY: _______________
FAX NUMBER: _____________________
KPMI PART NO. / DESCRIPTION
PRICE
TOTAL $: _____________
NOTES
1
2
3
4
5
6
7
8
9
10
NAME ON CARD: _________________________________
VISA
COMMENTS: ___________________
CARD NUMBER: _________________________________
MASTERCARD
______________________________
EXP DATE: _______________ SEC CODE: ____________
AMER. EXP.
______________________________
OTHER
CONTACT IF BACK ORDERED: Y ________ N _________
350
order 650-557-2046
______________________________
