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Fax Email Order Form

This document is an order form for Hawaiian Queen Coffee. It lists various coffee varieties available for purchase, including Estate, Extra Fancy, Peaberry, and Private Reserve coffees in whole bean or ground forms. The order form provides the product descriptions, prices per unit, and space to include quantities for each item ordered. It also requests billing and shipping information from the customer.

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HawaiianQueen Coffee
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© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
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110 views5 pages

Fax Email Order Form

This document is an order form for Hawaiian Queen Coffee. It lists various coffee varieties available for purchase, including Estate, Extra Fancy, Peaberry, and Private Reserve coffees in whole bean or ground forms. The order form provides the product descriptions, prices per unit, and space to include quantities for each item ordered. It also requests billing and shipping information from the customer.

Uploaded by

HawaiianQueen Coffee
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLS, PDF, TXT or read online on Scribd
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HAWAIIAN QUEEN COFFEE ORDER FORM

Date: Email: BILLING Addrs: City State Zip


73-5577 Olowalu Street Suite A Kailua Kona, HI 967402613 Toll Free: 888-452-5662 Tel: 808-326-2288 Fax: 808-326-2290 www.hawaiianqueencoff ee.com info@hawaiianqueencoff ee.com

Name: SHIPPING

Ctry Tel Fax CC # Exp: CW: Signature Full Whole Ground Medium City Dark Each 15.95 27.95 19.95 32.95 21.25 34.95 21.95 39.95 20.95 34.95 6.95 12.95 QTY Amount -

Description Estate - 8 oz. Estate - 1 lb Private Res - 8 oz. Private Res - 1 lb Extra Fancy - 8 oz. Extra Fancy - 1 lb Peaberry Coffee - 8 oz. Peaberry Coffee - 1 lb Decaffeinated - 8 oz. Decaffeinated - 1 lb 10% Kona Blend - 8 oz. 10% Kona Blend - 1 lb

Tax is waived if proper resale certificate is provided


Please tell us your preferred mode of shipment:

Sub-Total (this page) SHIPPING TAX (4.1667%) TOTAL

NOTES:

WHOLE BEAN DESCRIPTION 10% Kona Coffee BlendMedium-1 lb 10% Kona Coffee BlendMedium-8 oz Decaffeinated-Medium-1 lb Decaffeinated-Medium-8 oz Estate -Dark-1 lb Estate -Dark-5 lbs Estate -Dark-8 oz Estate -Full City-1 lb Estate -Full City-5 lbs Estate -Full City-8 oz Estate -Medium-1 lb Estate -Medium-5 lbs Estate -Medium-8 oz Extra Fancy-Dark-1 lb Extra Fancy-Dark-5 lbs Extra Fancy-Dark-8 oz Extra Fancy-Full City-1 lb Extra Fancy-Full City-5 lbs Extra Fancy-Full City-8 oz Extra Fancy-Medium-1 lb Extra Fancy-Medium-5 lbs Extra Fancy-Medium-8 oz Peaberry-Dark-1 lb Peaberry-Dark-5 lbs Peaberry-Dark-8 oz Peaberry-Full City-1 lb Peaberry-Full City-5 lbs Peaberry-Full City-8 oz PRICE 12.95 6.95 34.95 20.95 27.95 120.95 15.95 27.95 120.95 15.95 27.95 120.95 15.95 34.95 157.95 21.25 34.95 157.95 21.25 34.95 157.95 21.25 39.95 188.95 21.95 39.95 188.95 21.95 QTY

DESCRIPTION

PRICE

QTY -

10%KonaCoffeeBlend-Med-1lb 12.95 - 10%KonaCoffeeBlend-Med-8oz 6.95 - Decaffeinated-Medium-1 lb - Decaffeinated-Medium-8 oz Estate -Dark-1 lb Estate -Dark-5 lbs Estate -Dark-8 oz Estate -Full City-1 lb Estate -Full City-5 lbs Estate -Full City-8 oz Estate -Medium-1 lb Estate -Medium-5 lbs Estate -Medium-8 oz Extra Fancy-Dark-1 lb Extra Fancy-Dark-5 lbs Extra Fancy-Dark-8 oz Extra Fancy-Full City-1 lb 34.95 20.95 27.95 120.95 15.95 27.95 120.95 15.95 27.95 120.95 15.95 34.95 157.95 21.25 34.95 157.95 21.25 34.95 157.95 21.25 39.95 188.95 21.95 39.95 188.95 21.95 39.95

- Extra Fancy-Full City-5 lbs - Extra Fancy-Full City-8 oz - Extra Fancy-Medium-1 lb - Extra Fancy-Medium-5 lbs - Extra Fancy-Medium-8 oz Peaberry-Dark-1 lb Peaberry-Dark-8 oz Peaberry-Full City-1 lb Peaberry-Full City-5 lbs

- Peaberry-Full City-5 lbs - Peaberry-Full City-8 oz - Peaberry-Medium-1 lb

Peaberry-Medium-1 lb Peaberry-Medium-5 lbs

39.95 188.95

- Peaberry-Medium-5 lbs - Peaberry-Medium-8 oz - Private Reserve -Dark-1 lb - Private Reserve -Dark-5 lbs - Private Reserve-Dark-8 oz - Private Reserve-Full City-1 lb

188.95 21.95 32.95 145.95 19.95 32.95

Peaberry-Medium-8 oz 21.95 Private Reserve -Dark-1 lb 32.95 Private Reserve -Dark-5 lbs 145.95 Private Reserve-Dark-8 oz 19.95 Private Reserve-Full City1 lb 32.95 Private Reserve-Full City5 lbs 145.95 Private Reserve-Full City8 oz 19.95 Private Reserve-Medium1 lb 32.95 Private Reserve-Medium5 lbs 145.95 Private Reserve-Medium8 oz 19.95 Total Column 1

- Private Reserve-Full City-5 lbs 145.95 - Private Reserve-Full City-8 oz - Private Reserve-Medium-1 lb 19.95 32.95

- Private Reserve-Medium-5 lbs 145.95 - Private Reserve-Medium-8 oz Total Column 2 Total Column 1 Sub-Total 19.95

PURCHASE ORDER FOR INDIVIDUAL SALES AND RETAILERS


Date: Email: BILLING Address: City State Zip Country 73-5577 Olowalu Street Suite A Kailua Kona, HI 96740-2613 Toll Free: 888-452-5662 Tel: 808-326-2288 Fax: 808-326-2290
www.hawaiianqueencoffee.com [email protected]

Name:

SHIPPING

Tel Fax CC # Exp: CW: Signature

Description Estate - 8 oz. Estate - 1 lb Private Res - 8 oz. Private Res - 1 lb Extra Fancy - 8 oz. Extra Fancy - 1 lb Peaberry Coffee - 8 oz. Peaberry Coffee - 1 lb Decaffeinated - 8 oz. Decaffeinated - 1 lb Description 10% Kona Blend - 8 oz. 10% Kona Blend - 1 lb

Whole

Ground Medium Full City

Dark

Each 27.95 27.95 19.95 32.95 21.25 34.95 21.95 39.95 20.95 34.95

QTY

Amount

Whole

Ground Medium Full City

Dark

Each 6.95 12.95

QTY

Amount

Tax is waived if proper resale certificate is provided Please tell us your preferred mode of shipment: NOTES:

Sub-Total (this page) #REF! DISCOUNT SHIPPING TAX (4.667%) TOTAL

USE THIS SIDE IN ADDITION OR RATHER THAN THE FRONT SIDE TO PLACE YOUR ORDER IF YOU PREFER
COLLUMN 1 COLLUMN 2

WHOLE BEAN DESCRIPTION 10% Kona Coffee Blend-Medium-1 lb 10% Kona Coffee Blend-Medium-8 oz Decaffeinated-Medium-1 lb Decaffeinated-Medium-8 oz Estate -Dark-1 lb Estate -Dark-5 lbs Estate -Dark-8 oz Estate -Full City-1 lb Estate -Full City-5 lbs Estate -Full City-8 oz Estate -Medium-1 lb Estate -Medium-5 lbs Estate -Medium-8 oz Extra Fancy-Dark-1 lb Extra Fancy-Dark-5 lbs Extra Fancy-Dark-8 oz Extra Fancy-Full City-1 lb Extra Fancy-Full City-5 lbs Extra Fancy-Full City-8 oz Extra Fancy-Medium-1 lb Extra Fancy-Medium-5 lbs Extra Fancy-Medium-8 oz Peaberry-Dark-1 lb Peaberry-Dark-5 lbs Peaberry-Dark-8 oz Peaberry-Full City-1 lb Peaberry-Full City-5 lbs Peaberry-Full City-8 oz Peaberry-Medium-1 lb Peaberry-Medium-5 lbs Peaberry-Medium-8 oz Private Reserve -Dark-1 lb Private Reserve -Dark-5 lbs Private Reserve-Dark-8 oz Private Reserve-Full City-1 lb Private Reserve-Full City-5 lbs Private Reserve-Full City-8 oz Private Reserve-Medium-1 lb Private Reserve-Medium-5 lbs Private Reserve-Medium-8 oz Total Column 1

PRICE 12.95 6.95 34.95 20.95 27.95 120.95 15.95 27.95 120.95 15.95 27.95 120.95 15.95 34.95 157.95 21.25 34.95 157.95 21.25 34.95 157.95 21.25 39.95 188.95 21.95 39.95 188.95 21.95 39.95 188.95 21.95 32.95 145.95 19.95 32.95 145.95 19.95 32.95 145.95 19.95

QTY

GROUND DESCRIPTION 10%KonaCoffeeBlend-Med-1lb 10%KonaCoffeeBlend-Med-8oz Decaffeinated-Medium-1 lb Decaffeinated-Medium-8 oz Estate -Dark-1 lb Estate -Dark-5 lbs Estate -Dark-8 oz Estate -Full City-1 lb Estate -Full City-5 lbs Estate -Full City-8 oz Estate -Medium-1 lb Estate -Medium-5 lbs Estate -Medium-8 oz Extra Fancy-Dark-1 lb Extra Fancy-Dark-5 lbs Extra Fancy-Dark-8 oz Extra Fancy-Full City-1 lb Extra Fancy-Full City-5 lbs Extra Fancy-Full City-8 oz Extra Fancy-Medium-1 lb Extra Fancy-Medium-5 lbs Extra Fancy-Medium-8 oz Peaberry-Dark-1 lb Peaberry-Dark-8 oz Peaberry-Full City-1 lb Peaberry-Full City-5 lbs Peaberry-Full City-5 lbs Peaberry-Full City-8 oz Peaberry-Medium-1 lb Peaberry-Medium-5 lbs Peaberry-Medium-8 oz Private Reserve -Dark-1 lb Private Reserve -Dark-5 lbs Private Reserve-Dark-8 oz Private Reserve-Full City-1 lb Private Reserve-Full City-5 lbs Private Reserve-Full City-8 oz Private Reserve-Medium-1 lb Private Reserve-Medium-5 lbs Private Reserve-Medium-8 oz Total Column 2 Total Column 1 Sub-Total

PRICE 12.95 6.95 34.95 20.95 27.95 120.95 15.95 27.95 120.95 15.95 27.95 120.95 15.95 34.95 157.95 21.25 34.95 157.95 21.25 34.95 157.95 21.25 39.95 188.95 21.95 39.95 188.95 21.95 39.95 188.95 21.95 32.95 145.95 19.95 32.95 145.95 19.95 32.95 145.95 19.95

QTY

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