Westlake Medical Building
32144 Agoura Rd.
Sizes & Pricing:
#A: Door Sign
1.625"h x 13"w
Gold w/Black Letters
$55.00ea.
#B: Frame for above
1.75"h x 13.25"w
Flat Black
$75.00ea. (installed)
*Logos are extra charge.
* Prices do not include Shipping ($9.75) or Sales Tax (7.25%)

Please fill out and print this form, then fax it to (805) 581-1947. Also, mail a copy of this form with your check...or put your Credit Card information at the bottom of this form. We accept M.C. VISA & Discover credit cards or check cards.

Qty (each) Please type your Co. name(s) & Suite # as you would like them to read for each sign.
#A: Door Sign
 Name    
#B: Frame for above.    

Ordered & Approved By:
Contact Name:
Contact e-mail:
Contact Ph#:
Contact Fax#:
Ship To:
Name:
Address:
City, State:
Zip:
Sub Total:
Tax: (8.25%)
Shipping:
Total:

Please Remit Check or Money Order of Total Amount Due to;
Signcerely
628 Bluegrass St. 
Simi Valley, CA 93065
Ph# 805-527-6838
Fax# 805-581-1947
e-mail; signcerely@sbcglobal.net

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