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
PULSE BOILERS
PART NUMBER
ITEM DESCRIPTION
ITEM PRICE
QUANTITY
62-3333
REPLACEMENT BLOWER A50/100
$350.00 ea
BM-7131
REPLACEMENT BLOWER A100B/AM100
$350.00 ea.
BM-7132
REPLACEMENT BLOWER A150/AM150
$450.00 ea.
BM-7256
REPLACEMENT IGNITION MODULE
$475.00 ea.
BM-8197
5 YEAR TUNE UP KIT 100
$99.00 ea.
BM-8198
Circulator Motor (UP26-64F)
$100.00 ea.
BM-8199
5 YEAR TUNE UP KIT 300
$124.00 ea.
Total Item Price
Indicate state to calculate sales tax
NY
NJ
Other
Total Order Shipping and Handling
Total Cost of Order
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