RMX Logo 18371 Enterprise Lane
Huntington Beach, CA 92648
(714) 841-1899
PAK-RAK ORDER FORM


Your First and Last Name:
Street Address (Line 1):
Street Address (Line 2):
City: State:
E-mail Address:
Zip Code: Voice Phone #:
Voice Phone # for Delivery:

If the SHIP TO information is different than above, please supply the address below.
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Pak - Rak Motorcycle Standard Pickup Version $3100.00 + $90 Skid
Pak - Rak Motorcycle SP Pickup Version $3100.00 + $90 Skid
Pak - Rak Motorcycle VR Truck/Van Version $3500.00 + $160 Skid
Pak - Rak Watercraft Version $3100.00 + $90 Skid
Truck Freight (Select Method Below)
SHIP VIA:
Note: Shipment Made via Truck FOB Huntington Beach, CA. If shipment is made FREIGHT COLLECT payment will be made by you to the trucking line for shipment costs when the unit is delivered. If you select FREIGHT PREPAID we will add the cost of shipping to your invoice.
State and Local Tax ( CA Residents):
Your Total:
(May Not Include Freight)
Installation Costs Are Extra (if applicable)
Please advise truck type & measured bed length.
Truck:
Model:
Bed Height x Length:
The following marketing information would be helpful.
How did you hear about the RAK?
What type of motorcycle/watercraft do you drive?
Prices subject to change without notice.

Please enter any comments you may have about your order:

Payment By: I will call with my Visa # I will call with my Mastercard #
Please Call Me for an Order

We will gladly accept Visa/MC with your order by phone.

Deposit of $100.00 required with initial order to confirm delivery date. Balance due upon shipment. Normal delivery will ship approx 2 weeks ARO. The lead time can be longer during rally season. Please check.. Personal Checks, Visa and Mastercard are acceptable. FOB Huntingtion Beach, California. Voice Ordering is available by calling 714-841-1899.




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Deltronix Enterprises, Most recent revision: Tuesday, Oct. 21.2005