Order SALES ORDER AGREEMENT AND CREDIT CARD AUTHORIZATION FORM Fields marked with an * are required ORDER CONTACT FULL NAME:*ORDER CONTACT EMAIL:* ORDER CONTACT PHONE:*COMPANY/AGENCY:*PURCHASE ORDER/JOB NUMBER:A forklift is required at the delivery location.*You are responsible for offloading the pallets from the delivery vehicle, (Forklift with a minimum weight of 5,000 lbs). Otherwise, please contact us if you need additional accommodations.AgreeDisagreePLEASE SPECIFY HOW YOU'LL BE OFFLOADING YOUR ORDER:PRODUCT QUANTITY:**200 Filled Min/500 Empty MinPRODUCT SELECTION:* Black Polypropylene Sandbags Black Polyethylene Sandbags Orange Polypropylene Sandbags White Polypropylene Sandbags Tote/Bulk Bag Black Double Reinforced Polyethylene Sandbags Burlap Sandbags GeoTex Fabric Custom Sandbags High-Strength Military Sandbags Straw Wattles Yellow Monofilament Sandbags Straw Blankets Silt Socks Silt Fencing Hay Bales Tubular Water Bladder GeoTex/Non-Woven Bag Nylon Sandbags With Handles Purple Heat De-Icer 50lb Bag Purple Heat De-Icer 2000lb Tote PACKAGING OPTIONS:*Choose one or more options. (optional) Select All Bulk Bag(s) Pallet(s) Shrink Wrapped PRODUCT TYPE:*Do you need the bags filled or unfilled? if applicableFilledUnfilledPREFERRED DELIVERY DATE:* Date Format: MM slash DD slash YYYY DELIVERY TIME FRAME:*DELIVERY ADDRESS:* Street Address Address Line 2 City State ZIP / Postal Code DELIVERY DAY CONTACT:*DELIVERY PHONE:*SPECIAL INSTRUCTIONS:BILLING PHONE:*BILLING EMAIL:* BILLING ADDRESS:* Street Address Address Line 2 City State ZIP / Postal Code PAYMENT METHOD:*- Select payment method -ACHCredit CardPay Later (upon approval of credit)ACH PAYMENT AMOUNT:PAYMENT AMOUNT:* Credit Card (Do not enter dashes) American ExpressDiscoverMasterCardVisa Card Number Expiration Date MM010203040506070809101112 YYYY20202021202220232024202520262027202820292030203120322033203420352036203720382039 Security Code Cardholder Name REQUIRED FIELD* I agreeI understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature. By checking this box and typing my name below, I electronically sign this credit card authorization form.DISCLAIMER: NO RETURNS ARE ACCEPTED. ALL SALES ARE FINAL. Once this Sales Order Agreement has been confirmed by Sandbagstogo.com, LLC it may only be changed by written agreement signed by both Company and Sandbagstogo.com, LLC. In the event that a truck is unable to access the delivery location on the day of delivery and/or is delayed or rescheduled at no fault of its own, there will be an additional cancellation fee assessed at the discretion of the trucking company. Sandbagstogo.com, LLC makes no express or implied warranties of merchantability or representations as to the fitness of the products for any particular use or purpose.Total $0.00 TYPE YOUR NAME HERE:*Card will be charged upon receipt, one-time for the amount indicated. I certify that I am an authorized user of the credit card and that I will not dispute the payment with my credit card company, so long as the transaction corresponds to the terms indicated on this form.DATE* Date Format: MM slash DD slash YYYY Save and Continue Later This iframe contains the logic required to handle Ajax powered Gravity Forms.