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New York City Department of Transportation Sign …

Sign Sales Program Order Form Order by mail or fax. New York City Department of Transportation. PLEASE PRINT ALL INFORMATION. Your …

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Text of New York City Department of Transportation Sign …

Sign Sales Program Order FormOrder by mail or faxNew York City Department of TransportationPLEASE PRINT ALL INFORMATIONYour Name: ________________________________________ ________________________________________ ___________________________________ Contact Person: ________________________________________ ____________Company Name: ________________________________________ ________________________________________ __________________________ Tax Exempt #: ________________________________________ ________________City: ________________________________________ ________________________________________ ______________________ State: ______________________________________ Zip Code: ____________________________________Tele phone #: ________________________________________ ________________________________________ ________ Fax #: ________________________________________ ________________________________________ _______________Signature: ________________________________________ ________________________________________ ____________ Date: ________________________________________ ________________________________________ ________________Shipping Information (if different from above)Name or Company Name: ________________________________________ ____________ Address: ________________________________________ ________________________________________ ___________________________ City: ________________________________________ ________________________________________ _________ State: ________________________________________ ______________ Zip Code: ____________________________________FOR AGENCY USE ONLYREQ. #: S10- -Order DetailsSIGNSPRICINGITEM #ITEM NAMECOLORSDESCRIPTIONQT PRICELOGOAdd $ BRACKET Add $ LADDITIONAL SPACE FOR SIGN DESIGN / DESCRIPTIONORDER SUBTOTAL(NYC residents add current sales tax) TAX(Call For Shipping Costs) GRAND TOTALSubmit Your Order:By mail: New York City Department of Transportation Sign Sales Program 58-50 57th Road Maspeth, NY 11378 Phone: of Payment (Check One): Visa Card Master CardCredit Card #: ________________________________________ ____________________________________CSC Code #: _________________________________Expirat ion Date: ____________________________ Money Order Check Make payable to: NYC DOT Sign Sales*DO NOT SEND CASH*

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