Fuel Injector Man

5307 Shirley Street, Suite W

Naples, Fl. 34109

1-888-771-3835 / 239-591-3332

Name : ____________________________________________________ Date : ________________

Shipping Address :________________________________________________________________________

City : ____________________________________________ State : _____________ Zip : _____________

Phone : ______________________________ E-Mail : ___________________________________________

Outboard / Injector Information

Outboard Make_________________ Outboard HP______________ Model ___________________

 

Total Number Of Top Feed Injectors Shipped ____________ ( $20.00 each ) + Return Shipping and Insurance

Total Number Of Side Feed Injectors Shipped _____________ ( $26.00 each ) + Return Shipping and Insurance

Total Number of Etec Injectors Shipped ___________________($62.00 each) + Return Shipping and Insurance

Return Shipping / We currently use UPS

Please select how you would like your injectors returned shipped. UPS Ground ___ UPS Next Day ___

Your package is insured for $100.00 only ! Additional Insurance is 1.00 per $100.00

Extra Insurance : _____________________ ( $100, $200, $300, $400, $500 etc. )

If you choose not to carry extra Insurance for the Return Shipment

Fuel Injector Man will not cover the cost of replacing your injectors due to lost shipments

We Strongly recommend that you buy enough Insurance for you to replace your Injectors !

Payment

Fuel Injector Man uses PayPal " Pay By Invoice "

You Do Not have to have a PayPal account !

When we receive your injectors we will send you an E-mail / Invoice through PayPal.

The Invoice will show cleaning cost + shipping. Click on the link on the E-mail / Invoice to pay.

You can use any credit card Or a PayPal account to pay the invoice.

PayPal will send us back an e-mail stating that you have paid the bill.

We will send back your injectors at that time.

This is the safest way for you and us. PayPal site is secure/safe/and easy !

We do not see any credit card information which protects You !

You Must supply your e-mail address to get billed.

We do not share any information with others !

Thank You For your Business !