Page 66 of Cougar Parts and Accessories Part 2 by Auto Krafters, Inc.

NOTE: Please give a street address for shipping. UPS or truck lines will not deliver to a P.O. Box. Customer Gold Card Club Membership E-mail _____________________________ Total price of Qty. part number vehicle info Please check all that apply Sub Total Add Shipping and Handling Add $10.00 Boxing Fee for Sheet Metal Package Trays Includes: Hoods, Fenders, Quarter Panels, Toe Boards, Floor Pans Full and Half, Radiators, and Gas Tanks. Add $5.00 Rush Special Handling Fee Gives you priority over all other guaranteed orders. If we receive the order by 2:00 p.m. Eastern Standard Time and it is in stock, it will be shipped out the same day. Add Va. 5% Sales Tax (Va. Sales Only) Total minimum Order amount on Credit Card is $20.00 page year of no. vehicle Total price of items Qty. part number Description unit price Shipping and Handling Fee Chart These are standard UPS or FedEx Ground shipping amounts. Shipping quotes will be given for all air shipments and truck freight shipments upon request from the customer. mailing billing address Name Address City State Zip Daytime Phone Except for oversized and overweight items. Order Standard Total 7-10 Days $350.00 $499.99 .............$34.45 $500.00 $599.99 .............$38.45 $600.00 $699.99 .............$41.45 $700.00 $799.99 .............$48.45 $800.00 Up .....................FREE* Order Standard Total 7-10 Days $0.00 $49.99 .....................$9.95 $50.00 $99.99 .................$15.95 $100.00 $149.99 .............$19.95 $150.00 $249.99 .............$25.45 $250.00 $349.99 .............$30.45 Shipping address Name Address City State Zip Daytime Phone ________________ Credit Card Number ** **Enter last three digits after card number on back of card. Print Name on Card Signature of Cardholder Specify: q VISA q MasterCard Expiration q Am Ex q Discover 214 East Old Cross Road P. O. Box 1100 New Market, VA 22844 Phone (540) 740-8000 Fax Number (540) 740-8011 www.autokrafters.com Check method of payment: q Credit Card q Money Order or Cashiers check q Personal or Company Check (Order held 14 days for bank clearance.) A $1.50 insurance fee has been added to all orders over $150.00 Issue 2006 Year ____________ Engine ____________ Body Style ____________ Transmission ____________ Interior Code ____________ Interior Color

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