the Ball & Claw
29 America's Cup Ave., Newport, RI 02840
(401) 848-5600 fax (401) 848-5650
| Date |
Ordered by:
| Name | ||
| Address | ||
| City | State | Zip |
| Phone | ||
Ship to: (if different from above)
| Name | ||
| Address | ||
| City | State | Zip |
| Qty | Item | Price ea. | Shipping | Total |
|
Subtotal |
||||
| RI residents add 7% sales tax | ||||
| TOTAL | ||||
Payment information:
| Circle one: Check enclosed / Visa / Mastercard / Amex | |
| Card # | Exp. |
| Name on card | |