Customers are our Number One Priority.
All of us at CLARCOR Air Filtration Products, Inc., representing the Purolator Brand,
look forward to serving you.

3807 Bishop Lane • P.O.Box 32578
Louisville, KY 40218
Phone: (502) 969-2304 ext. 1
Toll Free: 1-866-925-2247
Fax: 1-800-784-3458
info@purolatorair.com
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Contact information

Non Credit Approved Customers
Product Sample Order Form


Please complete this form to order Purolator product samples.

*Field Required

*Customer PO Number *
 
*Sold To:
Name:
Address:
 
City:
Phone:
Email:
*Ship To:
Name:
Address:
 
Phone:
City:
*
 Item Number *Description *Size *Price
50% discount		 Case
Qty
1
2
3
4
 
5
CC TYPE
Credit Card Number
AMERICAN EXPRESS, VISA & MASTER CARD ONLY
6
Expiration Date
Company Name
Card Holder Name

*FREIGHT PREPAID AND ADD

This form is directed to the Customer Care Department of
CLARCOR Air Filtration Products, 3807 Bishop Lane, Louisville, KY 40218
My fax: 1-866-607-5380 - General Fax 1-800-784-3458
Shawn Avdevich

© 2007 CLARCOR All rights reserved.