Tri State Butt Buffer Order Form

Welcome to the Tri State Butt Buffer Order Form!

*FIRST:	*LAST:	MI:
*ADDRESS 1:	ADDRESS 2:
*CITY:	*STATE:
*ZIP Code:	*EMAIL:
*Phone Number:
* All items marked with asterisk are required entries

Please Select a Credit Card Type:
Please Enter Your Credit Card Number(Numbers only):
Please Enter Expiration Date: MonthYEAR(YYYY)
Please Enter Three Digit CCV from back of card: CCV

To insure accurate and timely service, please click "check entries" prior to submitting your order. Thank you!

Choose Products by:

Using the size chart to choose product sizes for your cycle.

Entering a quantity for the item selected.

Price per item is automatically reduced by 5 dollars for orders of two or more.

Choosing a fabric type, color, or style as appropriate.

Butt Buffer Top Cushions
Please enter quantity:	Description	Price per unit	Fabric Type	Color
	P-Pad 8" X 11"	$56.00
	Small 12" X 12"	$73.00
	Medium 12" X 16"	$88.00
	Large 14" X 18"	$107.00
Eagle Series/Wolf Edition		Price/Unit		Choose Type
	Small With Fringes	$115.00
	Small No Fringes	$90.00
	Medium with Fringes	$130.00
	Medium No Fringes	$110.00
	Large with Fringes	$140.00
	Large no Fringes	$125.00
Specialty Cushions		Price		Color
	Wheel Chair All Poly	$250.00		Black Only
	Wheel Chair Poly/Foam	$350.00		Black Only
	English Saddle three eights Poly	$125.00		Black Only
	Western Saddle three eights Poly	$125.00		Black Only
	English Saddle half inch Poly	$150.00		Black Only
	Western Saddle half inch Poly	$150.00		Black Only
	Sports Pad 18 X 19	$119.00		Black Only
	Medium Confederate Flag	$109.00		N/A
	Large Confederate Flag	$119.00		N/A
	Medium POW*MIA	$109.00		N/A
	Large POW*MIA	$119.00		N/A
	Small Sheepskin	$115.00		N/A
	Medium Sheepskin	$135.00		N/A
	Large Sheepskin	$155.00		N/A
	HEDZ Headwear	$15.00		N/A
Installations				Price
	P-Pad installed in your existing seat			$110.00
	P-Pad and small insert installed in your existing seat			$210.00
	P-Pad and medium insert installed in your existing seat			$225.00
	P-Pad and large insert installed in your existing seat			$240.00
	Small insert installed in your existing seat			$120.00
	Small insert installed in your existing seat(front&rear)			$210.00
	Small and medium insert installed in your existing seat			$250.00
	Small and large insert installed in your existing seat			$250.00
	Medium insert installed in your existing seat			$140.00
	Medium insert installed in your existing seat (front&rear)			$250.00
	Medium and large insert installed in your existing seat			$260.00
	Large insert installed in your existing seat			$150.00
	Large insert installed in your existing seat (front&rear)			$280.00
Unique Additional Installation Costs (Enter QTY)
	Install Involves Riveted Seats			$25.00
	Install Involves Glued Seats			$25.00
	Install Involves Riveted and Glued Seats			$45.00
	Existing Gel insert replaced			$50.00
Enter Total Quantity and Delivery Method of Items to be Shipped
	Standard Ground UPS Cushions			$12.00
	Standard Ground UPS Seats			$22.00
	3 Day UPS Cushions			$22.00
	3 Day UPS Seats			$32.00
**Next Day Air Prices will be actual cost and provided upon request.
ORDER TOTAL