Product Order Form

PRODUCT PRICE/UNITS QTY TOTAL
The
Infection
Control
Towel™
$14.99 per Box
(contains 45 towels)
$
$149.99 per Case
(contains 12 boxes)
$
$1499.99 per 10 Cases $
Hand Rub™ $2.00 per 2 oz. Bottle $
$23.75 per 2 oz. Case
(contains 12 2 oz. bottles)
$
$3.50 per 4 oz. Bottle $
$41.65 per 4 oz. Case
(contains 12 4 oz. bottles)
$
Ibutab™ $19.86 per Box
(contains 250 packets of 2 tablets ea)
$
$239.40 per Case
(contains 12 boxes)
$
TAC-tab™ $19.86 per Box
(contains 250 packets of 2 tablets ea)
$
$239.40 per Case
(contains 12 boxes)
$
PreGame™ $30.00 per Bottle
(contains 120 capsules)
$
Grand Total $
PERSONAL INFORMATION
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