Make check payable to: To order please print this form and mail with  payment.    Date:________________
D & D Chemical, Inc.
2065 Marion Ln.
Kinston, NC 28504
 		 You may Fax your order to:   1-252-523-8255
Mail to: Ship to: Phone:
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_____________________ _____________________ Email:
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(  )UPS                                      (  ) US Postal Service Name on Card:____________________________ 

Card Number: ________________________________        Exp: ________________     

* Products will be shipped when out of state check have cleared our bank.
Description                   Price                   Quantity         Total Cost
Eliminator Foundation Vent Fan  $98.50                   _______          ________
Timbor (Fungicide) Wood Treatment 1lbs Packs  $9.95                   _______          ________
Timbor (Fungicide) Wood Treatment 25lbs  $115.00                   _______          ________
Power Temp-Vent Fan                                              Color:  (  ) Black,       (  ) Brown,   (   ) Gray  $138.00                   _______          ________
De-humidistat Control Switch  $24.95                   _______          ________
Santa Fe Crawlspace Dehumidifier *  $935.00                   _______          ________   
    North Carolina Sales Tax 6%  
    Shipping & Handling             $12.75           *58.95
                          Total Cost        $ ________