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BISSELL CleanView Order Form
Order Information
Item Part No. Part Name Qty. x Unit = Total
Price
1 32074 Style 7 Drive Belt (2 pack) ______ $2.99 ______ ______
2 203-1007 Headlight Bulb ______ $1.95 ______ ______
3 203-1063 Crevice Tool ______ $2.99 ______ ______
4 203-1083 Dusting Brush ______ $1.70 ______ ______
5 203-1084 Extension Wand ______ $1.50 ______ ______
6 203-1164 Vacuum Hose ______ $8.95 ______ ______
7 203-1036 Wire Reinforced
Vacuum Hose Gray ______ $12.95 ______ ______
8 203-2012 Wire Reinforced
Vacuum Hose Clear ______ $14.95 ______ ______
9 203-2032 Brush Roll ______ $15.95 ______ ______
10 203-2013 Power Trak Brush Roll
(Select Models Only) ______ $17.95 ______ ______
11 203-1085 Upper Tank Filter ______ $3.99 ______ ______
12 203-1073 Pre-Motor Filter ______ $1.50 ______ ______
13 203-1009 Post-Motor Filter ______ $2.95 ______ ______
14 32076 HEPA Media Post-Motor
Filter (Select Models Only) ______ $9.99 ______ ______
SUB TOTAL ______
Sales tax based on delivery address Shipping ______
AR, AZ, CA, FL, GA, IL, KS, MA, MD, MI, MN, MO,
NC, NE, NJ, NY, OH, PA, TN, TX, UT and WA
residents add applicable sales tax. Sales Tax ______
Price applicable in continental United States only
Price subject to change without notice Order Total ______
Billing Information
Charge: Mastercard Enclosed in your envelope
check or money order
Visa payable to BISSELL Homecare, Inc.
(No cash or stamps please)
American Express
Discover
Telephone ________________________________________________________
Account
Number
(include all digits)
Card
Expires
Month Year Signature __________________________________
Or visit BISSELL website - www.bissell.com
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Shipping Information
Ship To ____________________________
Address ____________________________
____________________________
City ____________________________
State ____________ Zip____________
3
MAIL REORDER FORM TO:
BISSELL Homecare Inc.
Mail Order Department
PO Box 3606
Grand Rapids MI 49501
OR FAX TO:
1-616-791-7711
Shipping and Handling
.01 to $4.99 = $2.95
$5.00 to $19.99 = $4.95
$20.00 to $99.99 = $7.95
$100.00 to $229.99 = $13.95
$230.00 and up = $25.95
UPS 2nd Day = above shipping amount + $5.75
UPS Next Day = above shipping amount + $19.95
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