FAX ORDER FORM


Please fill in ALL requested information. If the field indicates "CALL", please call CelticParts to continue the order.


First Name

Last Name

Company Name

Contact Email Address

Phone Number

Fax Number
Shipping Address (No P.O. Boxes):


Street Address Line 1

Street Address Line 2

City

State

Zip

PARTS REQUIRED
PART NUMBER
ITEM DESCRIPTION
ITEM PRICE
QUANTITY
62-3333
Air Vent Assembly
$160.00 ea
62-3535
Retaining U-Clip
$11.00 ea.
62-3339
Expansion Tank
$175.00 ea.
BM-9077
Blower Assembly (FF models only)
$209.00 ea.
62-3394
Blower Motor only (FF models only
$179.00 ea.
BM-9098
Circulator Motor (UP26-64F)
$240.00 ea.
BM-9096
Circulator Motor (UP15-42F)
$185.00 ea.


Total Item Price


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Total Order Shipping and Handling
Total Cost of Order




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