ULSD and LSD Decals for On-Road, Off-Road and Kerosene Pumps ULSD (15 ppm) Pump Decals (H5105) Highway Low Sulfur (500 ppm) Pump Decals (H1446) q $1.69/decal (1-49 decals) Quantity: ___ q $1.49/decal (50-99 decals) Quantity: ___ q $1.29/decal (100+ decals) Quantity: ___ Total Highway LSD Pump Decals (H1446) $________ Grand Total $________ STAY EPA COMPLIANT! ORDER YOUR PUMP DECALS TO AVOID STEEP FINES. Non-Highway Low Sulfur (May exceed 500 ppm) Pump Decals (H1449) q $1.69/decal (1-49 decals) Quantity: ___ q $1.49/decal (50-99 decals) Quantity: ___ q $1.29/decal (100+ decals) Quantity: ___ Total Non-Highway LS Pump Decals (H1449) $________ Ultra-Low Sulfur Kerosene Pump Decals(15 ppm - Untaxed, Undyed) (H5156) q $1.69/decal (1-49 decals) Quantity: ___ q $1.49/decal (50-99 decals) Quantity: ___ q $1.29/decal (100+ decals) Quantity: ___ Total ULS Untaxed Kero Pump Decals (H5156) $______ Low-Sulfur Kerosene Pump Decals (500 ppm - Taxed) (H1479) q $1.69/decal (1-49 decals) Quantity: ___ q $1.49/decal (50-99 decals) Quantity: ___ q $1.29/decal (100+ decals) Quantity: ___ Total LS Kero Pump Decals (H1479) $______ Low Sulfur Kerosene Pump Decals (500 ppm - Untaxed, Undyed) (H5158) q $1.69/decal (1-49 decals) Quantity: ___ q $1.49/decal (50-99 decals) Quantity: ___ q $1.29/decal (100+ decals) Quantity: ___ T otal LS Untaxed Kero Pump Decals (H5158) $_____ Non-Highway Kerosene Pump Decals (May exceed 500 ppm) (H1494) q $1.69/decal (1-49 decals) Quantity: ___ q $1.49/decal (50-99 decals) Quantity: ___ q $1.29/decal (100+ decals) Quantity: ___ Total Non-Highway Kero Pump Decals (H1494) $_____ For actual pump decal language, please see the reverse side. Low-Sulfur Non-Highway (500 ppm) Pump Decals (H5108) q $1.69/decal (1-49 decals) Quantity: ___ q $1.49/decal (50-99 decals) Quantity: ___ q $1.29/decal (100+ decals) Quantity: ___ Total Low-Sulfur Non-Highway Pump Decals (H5108) $_______ Heating Oil (May exceed 500 ppm) Pump Decals (H1598) q $1.69/decal (1-49 decals) Quantity: ___ q $1.49/decal (50-99 decals) Quantity: ___ q $1.29/decal (100+ decals) Quantity: ___ Total Heating Oil Pump Decals (H1598) $________ Non-Highway ULSD (15 ppm) Pump Decals (H5106) q $1.69/decal (1-49 decals) Quantity: ___ q $1.49/decal (50-99 decals) Quantity: ___ q $1.29/decal (100+ decals) Quantity: ___ Total Non-Highway Pump Decals (H5106) $________ q $1.69/decal (1-49 decals) Quantity: ___ q $1.49/decal (50-99 decals) Quantity: ___ q $1.29/decal (100+ decals) Quantity: ___ Total ULSD Pump Decals (H5105) $_______ Low-Sulfur Locomotive and Marine Diesel (500 ppm) Pump Decals (H5107) q $1.69/decal (1-49 decals) Quantity: ___ q $1.49/decal (50-99 decals) Quantity: ___ q $1.29/decal (100+ decals) Quantity: ___ Total Non-Highway Pump Decals (H5107) $________ q Check enclosed (Make checks payable to OPIS — TIN: 26-3622417) q Charge my: qVISA qMC qAmEx qDiscover Card # Exp. Date Signature Name__________________________________________________________ Organization/Company ____________________________________________ Address ________________________________________________________ City __________________________ State ____________ ZIP ____________ Phone ________________________ Fax _____________________________ E-mail _________________________________________________________ Company Information Payment Options Overnight orders must be submitted prior to 5:00 pm EST to guarantee next day delivery. Please note: there are no refunds for decals that have been shipped. *Overnight Delivery: Add $19.95 (optional) $_______ Ultra-Low-Sulfur Kerosene Pump Decals (15 ppm - Taxed) (H5160) q $1.69/decal (1-49 decals) Quantity: ___ q $1.49/decal (50-99 decals) Quantity: ___ q $1.29/decal (100+ decals) Quantity: ___ Total ULS Kero Pump Decals (H5160) $______ Diesel On- and Off-Road Decals Kerosene and Heating Oil Decals Kerosene Heating Oil (May exceed 500 ppm) Pump Decals (H5157) q $1.69/decal (1-49 decals) Quantity: ___ q $1.49/decal (50-99 decals) Quantity: ___ q $1.29/decal (100+ decals) Quantity: ___ Total Kerosene Heating Oil Pump Decals (H5157) $________ Low Sulfur Locomotive and Marine Kerosene Pump Decals(15 ppm - Untaxed, Undyed) (H5159) q $1.69/decal (1-49 decals) Quantity: ___ q $1.49/decal (50-99 decals) Quantity: ___ q $1.29/decal (100+ decals) Quantity: ___ Total ULS Untaxed Kero Pump Decals (H5159) $______ NOTE: California has an EPA exemption for diesel labeling.