Bar Keepers Friend/Attn:  Lisa Neace
1100 Waterway Boulevard
Indianapolis, Indiana 46202

Mailing Address:                                                                                            Shipping Address (If different):
Name: ___________________________________________          Name:_____________________________________
Address:_________________________________________          Address:____________________________________
City:____________________________________________           City: ______________________________________
State: ______________________ Zip: _________________           State: ____________________ Zip: _____________
Phone: __________________________  Email: ______________________________

Payment Info. (circle one):       Check      Money-Order       MasterCard          Visa      Discover          American Express

Credit Card Number: ________________________      Expiration Date (ex. 10/08): _________

4 cans of Bar Keepers Friend  12 oz. Price $12.00 Quantity_____ Total_______
12 cans of Bar Keepers Friend 12 oz.   Price $20.00  Quantity_____ Total_______
4 cans of Bar Keepers Friend 21 oz.   Price $15.00  Quantity_____ Total_______
12 cans of Bar Keepers Friend 21 oz.   Price $26.00  Quantity_____ Total_______
250 1 oz. sample packs Bar Keepers Friend Powder  Price $40.00 Quantity_____ Total_______
400 1 oz. sample packs Bar Keepers Friend  Liquid Price $100.00 Quantity_____ Total_______
Bar Keepers Friend 25 lb. box  400 oz. Price $30.00 Quantity_____ Total_______
Bar Keepers Friend 40 lb. drum  640 oz. Price $50.00 Quantity_____ Total_______
Bar Keepers Friend 200 lb. drum (Must Add Freight)  Price $100.00 Quantity_____ Total_______
4 bottles of BKF Liquid 13 oz.   (Formerly Shiny Sinks Plus) Price $15.00  Quantity_____ Total_______
12 bottles of BKF Liquid 13 oz. (Formerly Shiny Sinks Plus) Price $20.00  Quantity_____ Total_______
3 bottles of BKF Liquid 26 oz.  (Formerly Shiny Sinks Plus) Price $15.00  Quantity_____ Total_______
9 bottles of BKF Liquid 26 oz. (Formerly Shiny Sinks Plus) Price $25.00  Quantity_____ Total_______
4 cans of Copper Glo Powder 12 oz.    Price $12.00  Quantity_____ Total_______
12 cans of Copper Glo Powder 12 oz. Price $17.00 Quantity_____ Total_______
4 bottles of Copper Glo Liquid 13 oz. Price $15.00  Quantity_____ Total_______
12 bottles of Copper Glo Liquid 13 oz. Price $20.00 Quantity_____ Total_______
2 bottles Just 'N Time Stain Remover 10 oz. Price $12.00 Quantity_____ Total_______
6 bottles Just 'N Time Stain Remover 10 oz. Price $25.00 Quantity_____ Total_______
4 bottles of BKF Lime Remover 16 oz.  Price $12.00 Quantity_____ Total_______
12 bottles of BKF Lime Remover 16 oz.  Price $29.00  Quantity_____ Total_______
6 bottles of BKF Cooktop Cleaner  13 oz. Price $15.00 Quantity_____ Total_______
1 Bar Keepers Friend Gift Basket   Price $19.95 Quantity_____ Total_______
1 Bar Keepers Friend Surprise Bargain Box Price $19.95 Quantity_____ Total_______
4 cans of Bar Keepers Friend Cookware 12 oz. . Price $15.00 Quantity_____ Total_______
12 cans of Bar Keepers Friend Cookware 12 oz. Price $25.00 Quantity_____ Total_______
1 bottle of Hexol 16 oz. Price $6.00 Quantity_____ Total_______
1 Christmas Apron Price $19.95 Quantity_____ Total_______
2 One Wipes Price $6.00 Quantity_____ Total_______
Merchandise Total: (Shipping and handling is included).   __________________
Indiana residents 6% Sales Tax (If applicable): __________________
Total Amount:         __________________