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AC1
17
www.primo-elektro.be
BESTELFORMULIER VOOR ONDERDELEN PRIMO-AC1
BULLETIN DE COMMANDE POUR PIèCES DETACHEES PRIMO-AC1
BESTELFORMULAR FÜR PRIMO-AC1
Vul het bestelformulier volledig in en stuur het per post op. Ondergetekende bestelt :
Complétez ce bulletin de commande et renvoyez-le par poste :
Bitte das Formular ausfüllen und mit der Post zurückschicken. Unterzeichnete bestellt :
PRIMO
BOUWELVEN 12A
2280 GROBBENDONK
AANTAL EENH.PRIJS TOTAAL
QUANTITE PRIX UNIQUE TOTAL
ANZAHL EINZELPREIS GESAMT
Motor lter / Filtre moteur .................................................... 5 ..................
Motor Filter
Glasvezel stofzak /Sac à pous. en bre de verre ..................... 8 € ..................
Glasfaser Staubbeutel
Metalen kuip 20 l /Cuve en métal de 20l ................................ 10 € ..................
Metallkübel 20 L
Kierenzuiger / Embout à fente .............................................. 4 € ...................
Fugendüse
Metalen slang / Tuyau en métal .............................................. 7 € ...................
Schlauch aus Metall
Flexibel /Flexible / Flexibel ................................................... 7 € ...................
Verzendkosten/frais d’envoi/ Versandkosten ........................................................................ 3,75 €
TOTAAL ............................................................................................................................................
De betaling dient voorafgaandelijk te gebeuren per overschrijving op rekening 552-2955000-40 (met ver-
melding PRIMO-AC1)
Paiement à l’avance par versement au n° bancaire 552-2955000-40 (avec mention PRIMO-AC1)
Bitte im voraus bezahlen mit Überweisung auf kontonummer 552-2955000-40 (Angabe PRIMO-AC1)
NAAM :.........................................................................................................................................................
NOM
NAME
ADRES : .......................................................................................................................................................
ADRESSE
TEL : ............................................................................................................................................................
DATUM + HANDTEKENING :
DATE + SIGNATURE
17


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