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WD2
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www.primo-elektro.be
BESTELFORMULIER VOOR WATERDISPENSER PRIMO-WD2
BULLETIN DE COMMANDE POUR FONTAINE A EAU PRIMO-WD2
BESTELFORMULAR FÜR WASSERSPENDER PRMO-WD2
Vul het bestelformulier volledig in en stuur het per post op naar :
Complétez ce bulletin de commande et renvoyez-le par poste à :
Bitte das Formular ausfüllen und mit der Post zurückschicken :
BENCO INTERNATIONAL
Ind. zone Klein Gent
Bouwelven 12 A
2280 Grobbendonk
AANTAL EENHEIDSPRIJS TOTAAL
Rubberen afsluiting essen +5 L 5,00 €
Fermeture en caoutchouc
pour bouteilles + 5 L
Gummiverschluss für +5 L Flaschen
Verzendkosten / Frais d’envoi / Versandkosten 3,75 € 3,75€
TOTAAL
TOTAL
GESAMTBEDRAG
Betaling dient voorafgaandelijk te gebeuren :
Overschrijven op rekeningnummer 552-2955000-40 met vermelding PRIMOWD2.
Paiement à l’avance :
Versement au n° bancaire 552-2955000-40 avec mention PRIMOWD2.
Bitte im voraus bezahlen :
Überweisung auf Kontonummer 552-2955000-40 Angabe PRIMOWD2
Naam : .........................................................................................................................
Nom
Name
Adres : ..........................................................................................................................
Adresse : .......................................................................................................................
Adresse :........................................................................................................................
Datum + handtekening :
Date + siganture
Datum + Unterschrift
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