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Home > Services > C&C Expedited Emergency Delivery Order Form

Order Form

Step 1: Billing Information (no payment information needed)
Company Name: Customer #:
Purchasing Agent: Telephone:
Email: Delivery Date:
Billing Address:
City: State:
Zipcode:    
 
Step 2: Shipping Address
Contact's Name
(if different from above):
Telephone #:
E-mail
(if different from above):
Delivery Date:
Shipping Address:  
Shipping City: Shipping State:
Shipping Zip:  
 
Step 3: Order Information
Quantity: Units:
Lubricant: ISO Grade:
Easy BarŪ size only: Type:
Packaging Type:    
Step 4: Submit Order

(Print and fax this form to 770-426-4167)

Disclaimer: I take full responsiblity of any charges, fees, etc., that incur for this emergency transaction. I waive my right to dispute any shipping charges and allow C&C to ship how they see fit.

C & C Oil Company
1591 Big Shanty Rd. | Kennesaw, GA 30144
PHONE: (770) 424 - 4093 | FAX: (770) 426 - 4167