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74763 (1/05) © 2005 Electrolux Home Care Products Ltd. Printed In China
SOLD TO:
Name
Address
City State Zip
Telephone (Day)
Telephone (Eve)
Fax
SHIP TO:
Name
Address
City State Zip
Telephone (Day)
Telephone (Eve)
Fax
PAYMENT (no C.O.D. Orders)
Check or money order. Do not send currency.
VISA DC MC AMEX
ACCT. NUMBER
EXPIRATION
DATE
SIGNATURE (full name as shown on acct.)
IMPORTANT: Be sure to include your model, type, and serial
numbers. These numbers may be found on the rating plate.
TO ORDER:
By Phone: 1-800-282-2886
Hours: Call Monday-Friday
8:00 am - 7:30 pm CST;
Saturday 10:00 am - 6:30 pm CST
(Please call the same number for
answers to problems or questions
in the USA and Canada)
En Mexico llame al:
(55) 5343-4384
By FAX: 1-309-589-7583
By Mail:
Simply fill out this Order Form.
Please be sure to include day and
evening phone numbers.
ONLINE
www.eureka.com
Payable to Electrolux Home Care Products North America
The Eureka Company
P.O. Box 3900 • Peoria, IL 61612
MODEL TYPE SERIAL
NUMBER NUMBER
Genuine Eureka Parts Part No. Qty. Price
(USD)*
Total
WATER TANK ASSEMBLY 74730 17.99
RECOVERY TANK ASSEMBLY 74409 27.99
NOZZLE ASSEMBLY 74418 14.99
NOZZLE BRISTLE STRIP 74747-355N 3.99
DETERGENT TANK ASSEMBLY 74430 5.99
32 OZ. CARPET & UPHOLSTERY 62383 5.99
SHAMPOO
64 OZ. CARPET & UPHOLSTERY 60170A 10.99
SHAMPOO
TOTAL (*prices subject to change without notice)
TAX (add state tax & local taxes as required by law)
POSTAGE & HANDLING CHARGE (within USA) $5.50
T O T A L E N C L O S E D