ORDER FORM Quantity 2013 Pinot Noir Sonoma County Half Case* $180.00 (6 Bottles) AZ Sales tax:$16.83 (*Minimum Quantity Available) 2013 Pinot Noir Sonoma County Unit Price Total Total: $196.83 Full Case $360.00 (12 Bottles) AZ Sales tax:$33.66 Total: $393.66 TOTAL: Please complete and fax form to 602-381-6577 or mail to The Monsignor, P. O. Box 45480, Phoenix AZ 85064-5480 AMEX, VISA, MasterCard and checks accepted. Make checks payable to Sierra Bonita Grill. The Monsignor Pick-Up Party Monday, December 8, 2014 – 5 pm to 7 pm Sierra Bonita Grill 6933 North 7th Street Phoenix, AZ 85014 Orders must be picked up by purchaser or representative at The Monsignor Pick-Up Party. To make other pick up arrangements, please call 602-381-6572. Name:___________________________________________________________________ Address:_________________________________________________________________ ________________________________________________________________________ City:__________________________ State:________ Zip:___________________ Credit card account number:_________________________________________________ Expiration Date:______/______ Signature:________________________________________________________________ E-mail:___________________________________________________________________ Contact phone number: _____________________________________________________
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