Klip Order Form · 2020. 11. 25. · ORDER FORM YOUR INFORMATION ANCHOR BATH CHAIR ANCHOR BATH CHAIR ACCESSORIES AN1400 Anchor Bath Chair, Sm AN1600 Anchor Bath Chair, Lg BATH CHAIR

ORDER FORM

YOUR INFORMATION

ANCHOR BATH CHAIR

ANCHOR BATH CHAIR ACCESSORIES

AN1400 Anchor Bath Chair, Sm

AN1600 Anchor Bath Chair, Lg

BATHCHAIR

Fax to 718.878.2283 • Email to info@circlespecialty.com

68 35th Street, Brooklyn, NY 11232 T: 718.943.6452 F: 718.878.2283 www.circlespecialty.com info@circlespecialty.com

ITEM # QTY DESCRIPTION MSRP

ITEM # QTY DESCRIPTION MSRP

Company: Ship To:

Account Number: Date: Address:

Quote PO Number: City: State:

Contact: Zip: Phone:

Email: Marked For:

AN2100 Anchor Rolling Shower Base

AN2110 Lateral Support

AN2111 Positioning Straps, XL, Pair

$645.00

$65.00

$38.00

$640.00

$660.00