Order Form, Face 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
HG-20 Ratchet headgear with sweatband (Face shield not included). $12.00 ea. $
HG-30H Ratchet headgear with oversized brow guard for severe and hot environments. (Face shield not included). $21.50 ea. $
VB-10 Visor Bracket mounts onto safety caps using SA-93/30/29 adapters, or with cap mount muffs HM-20/25/60/80. Accepts face shields. Fit chart. $7.95 ea. $
VB-20 Visor Bracket (for short brim safety helmets) mounts onto safety caps using SA-93/30/29 adapters, or with cap mount muffs HM-20/25/60/80. Accepts face shields. Fit chart. $7.95 ea. $
VB-30 Visor Bracket (for safety caps with sloping brim or elevated  accessory slots) mounts onto safety caps using SA-93/30/29 adapters, or with cap mount muffs HM-20/25/60/80. Accepts face shields. Fit chart. $7.95 ea. $
SA-93 Slot Adapter, fits VB-10 to slotted safety caps. This adapter fits most slotted caps. Fit chart. $3.55 ea. $
SA-30 Slot Adapter, fits VB-10 to slotted safety caps. Fit chart. $3.55 ea. $
SA-31 Slot Adapter, fits VB-10 to slotted safety caps. Fit chart. $3.55 EA. $
SA-29 Slot Adapter, fits VB-10 to slotted safety caps. Fit chart. $3.55 ea. $
FS-12A Clear molded Propionate shield, 8" X 12 X  0.06". For VB-10 only $5.35 ea. $
FS-12L Clear molded Lexan shield, 8" X 12" X 0.06", For VB-10 only. $7.90 ea. $
FS-12LG Green molded Lexan shield, 8" X 12" X 0.06", For VB-10 only. $7.90 ea. $
FS-15PC Clear, molded and curved shield, 8" X 15.5" X 0.04". Universal fit. $6.10 ea. $
FS-15PC-LG Light green, molded and curved shield, 8" X 15.5" X 0.04". Universal fit. $6.10 ea. $
FS-15P Clear, die cut economical Polycarbonate shield, 8" X 15.5" X 0.04". Universal fit, HG-20, HG-30 and VB-10. $4.25 ea. $
FS-15A Clear molded Propionate shield, 8" X 15.5" X 0.06". Universal fit, HG-20, HG-30 and VB-10. $6.50 ea. $
FS-15L Clear molded Lexan shield, 8" X 15.5" X 0.06". Universal fit, HG-20, HG-30 and VB-10. $8.80 ea. $
FS-15LG Green molded Lexan shield, 8" X 15.5" X 0.06". Universal fit, HG-20, HG-30 and VB-10. $8.80 ea. $
FS-15WS5 Welding shade 5 molded Propionate shield, 8" X 15.5" X 0.06". Universal fit, HG-20, HG-30 and VB-10. $18.25 ea. $
FS-16PC Molded aspherical Polycarbonate shield, 8" X 16" X 0.07". Universal fit, HG-20, HG-30H and VB-10. $8.90 ea. $
FS-18L Clear molded and oversized Lexan shield, 8" X 18" X 0.06". Universal fit, HG-20, HG-30 and VB-10. $12.30 ea. $
FS-18LG Green molded and oversized Lexan shield, 8" X 18" X 0.06". Universal fit, HG-20, HG-30 and VB-10. $12.30 ea. $
FS-15CL Clear molded and hard coated Lexan shield, 8" X 18" X 0.06". Universal fit, HG-20, HG-30 and VB-10. $16.00 ea. $
FS-18CL Clear molded and hard coated Lexan shield, 8" X 18" X 0.06". Universal fit, HG-20, HG-30 and VB-10. $21.00 ea. $
FS-18GL Green molded and gold coated Lexan shield, 8" X 18" X 0.06". Universal fit, HG-30 and VB-10. $93.00 ea. $
FS-18ARC10 ARC-Shield, 8 Cal/cm-2, risk category 2. Use with VB-10/20/30 only $40.90 ea. $
FS-20ARC10 ARC-Shield with Chin Protector, 10 Cal/cm-2. Use with VB-10/20/30 only. $46.90 ea. $
FS-21ARC10 Replacement ARC-Shield for FS-20ARC10 $40.90 ea. $
NV-70 Nylon Visor for all CU-systems. Fits VB-10/20/30 $8.00 ea. $
SV-70 Steel Visor for all CU-systems. Fits VB-10/20/30 $8.00 ea. $
SV-75 Steel Visor for HG-20 and HG-30H. 6.5" X 12.5" $8.00

ea.

$

SV-15H Heat reflecting steel visor, 24 gauge, 8" X 15.5". Fits VB-10, HG-20 and HG-30H. $16.85 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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