Order Form, Hearing Protection

Fax orders:  Print order form and fax with credit card and shipping information filled in.
Mail orders:  Print order form and mail with your check.
Phone orders:  Print or view order form and call Elvex at 800-888-6582. Have credit card ready (Visa and MasterCard only).

Industrial/Institutional prices may be lower. Contact your local safety equipment distributor for pricing information. Elvex will be pleased to provide name and addresses of a distributor in your area, when available.

Prod. # Product Name and Description
Unit Price
Quantity
Ordered
Total Cost
Disposable and reusable earplugs and banded earplugs      
EP-101 Elvex Uni-Fit, foam earplugs, 31 dB NRR, Box of 200 pair $26.00 ea. $
EP-113 Elvex Uni-Fit, corded foam earplugs, 31 dB NRR, Box of 100 pair $27.75 ea. $
EP-201 Elvex Blue, foam earplugs, 29 dB NRR, Box of 200 pair $27.00

ea.

$
EP-211 Elvex Blue, corded foam earplugs, Box of 100 pair $29.00 ea. $
EP-401-1 Quattro earplug, 25 dB NRR, one pair in poly-bag $0.68 ea. $
EP-401 Quattro earplug, 25 dB NRR, Box of 100 pair $68.30 ea. $
EP-402-1 Quattro earplug, with container & key chain, one pair $1.14 ea. $
EP-402 Quattro earplugs, with container & key chain, Box of 50 pair $57.00 ea. $
EP-411-1 Quattro earplug with cord, 25 dB NRR, one pair $0.96 ea. $
EP-411 Quattro earplugs, w. cord, Box of 100 pair $96.80 ea. $
EP-412-1 Quattro earplugs w, cord, container, key chain, one pair $1.42 ea. $
EP-412 Quattro earplugs w. cord, container, key chain, Box of 50 pair $71.00 ea. $
EP--413-1 Quattro earplugs w. cord, container, key chain, one pair $0.97 ea. $
EP-413 Quattro earplugs, w. PVC cord, Box of 100 pair $96.80 ea. $
EP-415-1 Quattro metal detectable earplug with cord, 25 dB NRR, one pair $1.31 ea. $
EP-415 Quattro metal detectable earplugs, w. cord, Box of 100 pair $131.30 ea. $
GP-10 GelPods, banded earplugs, 18 dB NRR $4.10 ea. $
GC-20 GelCaps, banded earplugs, 22 dB NRR $4.50 ea. $
Passive Earmuffs      
HB-25 ValueMuff, 25 dB NRR, comfortable and economical $9.40 ea. $
HB-35 MaxiMuff, 28 dB NRR, high performance at low price $13.10 ea. $
SS-25 Support Strap for HB-25/35 for use w. headband in neck position $0.50 ea. $
HB-550 UltraSonic Foldable high performance muff, 27 dB NRR $21.60 ea. $
HB-551 UltraSonic Foldable high performance muff, 27 dB NRR, with micro fiber draw-string protective bag $25.20 ea. $
HB-640 FlatLiner™ muff, 26 dB NRR, maximum comfort, stainless steel headband $17.80 ea. $
HB-650 UltraSonic muff, 29 dB NRR, high performance, stainless steel headband $19.70 ea. $
HB-2000 Equalizer earmuffs, 26 dB NRR, comfortable hi-tech muff $19.25 ea. $
HB-5000 SuperSonic earmuffs, 29 dB NRR, high performance, high tech $22.80 ea. $
Electronic earmuffs for communication and AM/FM radio earmuffs      
Com-75 Relax FM Radio earmuffs, 25 dB NRR, 2 AA 1.5V batteries (incl.). Normal price $144.0 - 20% off sale $115.20 $115.20 ea. $
Com-550 Elvex Impulse, Mil-Spec, electronic earmuff, 25 NRR, 4 AAA batteries included. Four hour auto off. Available mid March 2006. $93.00

ea.

$
Com-610 Plug-in hard wired headset, 3 adapters, 25 dB NRR $63.00 ea. $
Com-611 Plug-in hard wired headset, 3 adapters, 25 dB NRR $63.00 ea. $
Com-612 Plug-in hard wired headset, 3 adapters, 0 dB NRR $63.00 ea. $
Com-640 New generation: Elvex DeTune communications muff with high and low filters impulse filter. 29/36 dB NRS. 2 AAA batteries (incl.) (Check availability!) $128.00

ea.

$
Com-655 Electronic earmuff with impulse filter, level dependent, 25 dB NRR, 2 AAA batteries (incl.) $72.00

ea.

$
Com-660 QuieTunes AM/FM Radio earmuffs, 22 dB NRR, Outside battery compartment, 2 AA 1.5V batteries (incl.). 4-hour auto off. $81.00

ea.

$
Com-660R Rechargeable QuieTunes AM/FM Radio earmuffs, 22 dB NRR, Outside battery compartment, 2 AA 1.5V batteries (incl.). 4-hour auto off. $104.00 ea. $
Com-666 QuieTunes Pro AM/FM Radio earmuffs, 28/36 dB NRS, Outside battery compartment, 2 AA 1.5V batteries (incl.). 4-hour auto off. $90.00 ea. $
Com-666R Rechargeable QuieTunes Pro AM/FM Radio earmuffs, 28/36 dB NRS, Outside battery compartment, 2 AA 1.5V batteries (incl.). 4-hour auto off. $112.00 ea. $
Com-680 Aware, AM/FM radio earmuff with environmental listening, 22 DB NRR, Outside battery compartment, 2 AA 1.5V batteries (incl.). 4-hour auto off. $117.00 ea. $
Com-Kit Kit consisting of two connection wires for MP3 players and com radios, and a storage bag (SGB-30). Wires have 2.5 mm plug --> 3.5 mm plug, and 3.5 mm plug --> 3.5 mm plug. $22.00 ea. $
Com-Charger Charger for all Elvex rechargeable Com models, Com-260R, Com-660R, Com-80R $10.50 ea. $
HK-80 Hygiene Kit,  cushions and absorbers, for Com-80R and 110R and newer models of Com-25/55/65/75/100 $7.60 ea. $
HK-200 Hygiene Kit, cushions and absorbers, for Com-210/211/212/240/260 $6.80 ea. $

HK-600

Hygiene Kit,  cushions and absorbers, for Com-550, 655, 660, 660R, 666, 666R, 680 $7.80

ea.

$
SGB-30 Protective micro-fiber bag for ear muffs and goggles $4.00

ea.

$
. . . .  

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SUBTOTAL $ --- --- $

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CT Sales Tax, 6% (CT residents only) --- --- $

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Shipping and Handling --- --- $

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TOTAL ORDER $ --- --- $

Ship to:

Name, Title  
Company/Other Information  
Address  
City, State, Zip  
Phone  

Credit card:   VISA  (     )    MasterCard (     )

Credit card number:   ______________________

Credit card Expiration:  ____________________

Billing address, if different from above:

______________________________________

______________________________________

Order Information:
Please include payment with your order. Add shipping costs in accordance with shipping cost table to the right.

Shipping Charges for USA:

  • Minimum order is $30.00
  • For orders below $100.00 add $9.00 for shipping and handling
  • For orders between $100.00 and 250.00 add 9% for shipping and handling
  • For orders exceeding $250.00 add 7% for shipping and handling
International and express shipping orders:
Please inquire by fax or email.
Elvex Corporation, 13 Trowbridge Drive, P.O. Box 850, Bethel, CT 06801, USA
Phone: 800-888-6582, 203-743-2488, Fax: 203-791-2278, E-mail: Info@elvex.com

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