Cintas Brochure & Order Form - GoKeepRite!

ORDER FORM
EFFECTIVE DATE: November 2012
Page 1 of 3
SHIP TO: (Please Print) Date: ________________
Employee
Name: ____________________________________________________
Street: ______________________________________________ ___ _
City: ___________________________ County: ____________________
State: _____________________ Zip: _______________________
(Reference Number)
Daytime Phone: ( ______ ) ______________________________
BILL TO: (Please Print Date: ____________________
Name: _________________________________________________________ __________ _
Street: _______________________________________________
City: _______________________ County: _________________
State: ___________________ Zip: _______________________
Daytime Phone ( ______ ) ____________________________
Fax Number ( ______ ) _______________________________
P.O. Number (If applicable): _____________________________
Fax Number: ( ______) _________________________________
5600 West 73rd Street
Chicago, IL 60638
Call 1-877-368-0843
Fax: -513-459-1532
www.cintas.com
PREPAID INFORMATION
Enclose check or money order made payable to Cintas, or complete the charge card information
below:
Check/Money Order Number:_________
I authorize Cintas to charge my purchase to my:
Visa MasterCard Discover American Express
________________________________________Card Number________________________________________
Expiration Date
_________________________________________________________________________
Authorized Signature
STYLE &
COLOR #
DESCRIPTION
SIZE
RANGE
SIZE
TOTAL
QTY.
PRICE
EACH
TOTAL
AMOUNT
SHIRTS
935-23
935-23
935-31
935-31
935-38
935-38
935-88
935-88
831-00
831-00
831-15
831-15
831-20
831-20
831-21
831-21
831-30
831-30
831-31
831-31
831-33
831-33
831-35
831-35
831-44
831-44
831-60
831-60
831-68
831-68
831-80
831-80
831-88
831-88
831-94
831-94
66528-00
66528-00
Comfort Shirt® Work Shirt/Gray w/ Burgundy Stripe - LS *
Comfort Shirt® Work Shirt/Gray w/Burgundy Stripe - SS *
Comfort Shirt® Work Shirt/White w/Charcoal Stripe - LS *
Comfort Shirt® Work Shirt/White w/Charcoal Stripe - SS *
Comfort Shirt® Work Shirt/Charcoal w/Blue Stripe - LS *
Comfort Shirt® Work Shirt/Charcoal w/Blue Stripe - SS *
Comfort Shirt® Work Shirt/Lt. Blue w/Navy Stripe - LS *
Comfort Shirt® Work Shirt/Lt. Blue w/Navy Stripe -SS *
Dress Uniform Shirt/White - LS *
Dress Uniform Shirt/White - SS *
Dress Uniform Shirt/Red - LS *
Dress Uniform Shirt/Red - SS *
Dress Uniform Shirt/Navy - LS *
Dress Uniform Shirt/Navy - SS *
Dress Uniform Shirt/White w/Blue Stripe - LS *
Dress Uniform Shirt/White w/Blue Stripe - SS *
Dress Uniform Shirt/Lt. Gray - LS *
Dress Uniform Shirt/Lt. Gray - SS *
Dress Uniform Shirt/White w/Charcoal Stripe - LS *
Dress Uniform Shirt/White w/Charcoal Stripe - SS *
Dress Uniform Shirt/Charcoal - LS *
Dress Uniform Shirt/Charcoal - SS *
Dress Uniform Shirt/Gray w/Red Stripe - LS *
Dress Uniform Shirt/Gray w/Red Stripe - SS *
Dress Uniform Shirt/Hunter Green - LS *
Dress Uniform Shirt/Hunter Green - SS *
Dress Uniform Shirt/Tan - LS *
Dress Uniform Shirt/Tan - SS *
Dress Uniform Shirt/Tan w/Brown Stripe - LS *
Dress Uniform Shirt/Tan w/Brown Stripe - SS *
Dress Uniform Shirt/Lt. Blue - LS *
Dress Uniform Shirt/Lt. Blue - SS *
Dress Uniform Shirt/Blue w/Navy Stripe - LS *
Dress Uniform Shirt/Blue w/Navy Stripe - SS *
Dress Uniform Shirt/White w/Red Stripe - LS *
Dress Uniform Shirt/White w/Red Stripe - SS *
Female Dress Oxford Blouse/White - LS *
Female Dress Oxford Blouse/White - SS *
S - 5XL
S - 6XL
S - 4XL
XS - 7XL
S - 6XL
S - 7XL
S - 4XL
S - 6XL
S - 4XL
S - 4XL
S - 3XL
S - 5XL
S - 3XL
S - 4XL
S - 4XL
S - 6XL
S - 3XL
S - 3XL
S - 4XL
S - 5XL
S - 3XL
S - 3XL
S - 3XL
S - 4XL
S - 3XL
S - 3XL
S - 3XL
S - 3XL
S - 3XL
S - 3XL
S - 5XL
S - 6XL
S - 3XL
S - 4XL
S - 3XL
S - 4XL
4 - 30
4 - 34
Sleeve
Sleeve SS
Sleeve
Sleeve SS
Sleeve
Sleeve SS
Sleeve
Sleeve SS
Sleeve
Sleeve SS
Sleeve
Sleeve SS
Sleeve
Sleeve SS
Sleeve
Sleeve SS
Sleeve
Sleeve SS
Sleeve
Sleeve SS
Sleeve
Sleeve SS
Sleeve
Sleeve SS
Sleeve
Sleeve SS
Sleeve
Sleeve SS
Sleeve
Sleeve SS
Sleeve
Sleeve SS
Sleeve
Sleeve SS
Sleeve
Sleeve SS
Sleeve
Sleeve SS
Size
Size
Size
Size
Size
Size
Size
Size
Size
Size
Size
Size
Size
Size
Size
Size
Size
Size
Size
Size
Size
Size
Size
Size
Size
Size
Size
Size
Size
Size
Size
Size
Size
Size
Size
Size
Size
Size
13.05
11.80
13.05
11.80
13.05
11.80
13.05
11.80
13.75
11.45
13.75
11.45
13.75
11.45
16.45
14.10
13.75
11.45
16.45
14.10
13.75
11.45
16.45
14.10
13.75
11.45
13.75
11.45
16.45
14.10
13.75
11.45
16.45
14.10
16.45
14.10
11.00
9.50
*Official identification automatically applied to garments specified by the home office. Prices DO NOT include $3.00 for approved trim
DK2203 These garments are not returnable, unless defective, due to application of Direct Embroidery. Add $1.95 to Tops 2XL & Up.
Add $2.50 to Bottoms: Men’s 44" & Up and Ladies’ Size 24 & Up.
ICP_Keeprite130563 11/16/12