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| 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). |
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| Product # | Product Name and Description | Unit Price ea. | Quantity Ordered | Total Cost |
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--- Safety Glass Kits --- |
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| SG-20-Kit-1 | Three lens safety glass kit, with storage bags. | $23.20 | ea. | $ |
| SG-20-Kit-2 | Three lens safety glass kit, with storage bags | $24.10 | ea. | $ |
| SG-20-Kit-3 | Three lens safety glass kit, with storage bags. | $24.25 | ea. | $ |
| SG-20-Kit-4 | Two lens safety glass kit, with storage bags. | $18.10 | ea. | $ |
| SG-20-Kit-5 | Two lens safety glass kit, with storage bags. | $18.95 | ea. | $ |
| --- Hearing Protection, Ear Muffs --- | ||||
| Com-550 | Elvex Impulse, Mil-Spec, electronic earmuff w. bag and batteries, 25 dB NRR | $75.00 | ea. | $ |
| HB-551 | Elvex UltraSonic foldable high performance earmuff, with micro fiber draw-string bag, 27 dB NRR, CE Rating NA | $23.50 | ea. | $ |
| HB-25 | ValueMuff, Shooting ear muffs for basic training, 25 dB NRR, CE Rating 28 dB SNR | $8.80 | ea. | $ |
| HB-35 | MaxiMuff, Economical high performance muff, 28 dB NRR, CE Rating 30 dB SNR | $12.00 | ea. | $ |
| HB-650 | UltraSonic high performance muff, Steel fork type headband, 29 dB NRR, CE Rating 34 dB SNR | $18.30 | ea. | $ |
| HB-5000 | SuperSonic high performance muff, dielectric, contemporary design, 29 dB NRR, CE Rating NA | $21.40 | ea. | $ |
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--- Hygiene Kits = 2 ea. Ear Cushions and 2 ea. foam absorbers --- |
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| HK-600 | Hygiene Kit for Com-550 | $7.50 | ea. | $ |
| HK-25 | Hygiene Kit for HB-25 | $4.90 | ea. | $ |
| HK-35 | Hygiene Kit for HB-35 | $4.90 | ea. | $ |
| HK-650 | Hygiene Kit for HB-550 and HB-650 | $7.50 | ea. | $ |
| HK-2000 | Hygiene Kit for HB-2000 | $7.50 | ea. | $ |
| HK-5000 | Hygiene Kit for HB-5000 | $7.50 | ea. | $ |
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--- Hearing Protection, Ear Plugs --- |
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| Product # | Product Name and Description | Price/Box | Quantity ordered | Total Cost |
| EP-401 | Quattro, ear plugs
w/o cord, in zip-lock bag. NSN # 6515 01
492 0443.
Box of 100 pairs. |
$53.85 | ea. | $ |
| EP-402 | Quattro, ear plugs
w/o cord, and plastic pocket container. NSN #
6515 01 492 0456. Box of 50 pairs. |
$44.68 | ea. | $ |
| EP-411 | Quattro, ear plugs
with cord, in zip-lock bag. NSN #
6515 01 492 0458. Box of 100 pairs. |
$77.10 | ea. | $ |
| EP-412 | Quattro, ear plugs
with cord, and plastic container. NSN #
6515 01 492
0461. Box of 50 pairs. |
$55.49 | ea. | $ |
| EP-201 | Elvex Blue foam plugs w/o cord, box of 200 pairs | $30.00 | ea. | $ |
| EP-211 | Elvex Blue foam plugs with cord, box of 100 pairs | $32.50 | ea. | $ |
| EP-101 | Elvex Uni-Fit foam plugs w/o cord, box of 200 pairs | $25.20 | ea. | $ |
| EP-113 | Elvex Uni-Fit foam plugs with cord, box of 100 pairs | $26.85 | 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 $ | --- | --- | $ |
| Name, Title | |
| Institution, Organization | |
| Address | |
| City, State, Zip | |
| Phone |
Credit card: VISA ( ) MasterCard ( )Credit card number: ______________________ Credit card Expiration: ____________________ Billing address, if different from above: ______________________________________ ______________________________________
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Shipping Charges for USA:
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