Scottish Gourmet USA 1908 Fairfax Road, Suite B Greensboro, NC 27407 Toll-free phone: 877-814-3663 PHONE 336-663-7467 Email info@scottishgourmetusa.com BILLING ADDRESS Name ________________________________________________________ Address _______________________________________________________ City_____________________ State ______ Zip___________________ Phone (Required):________________________________________________ Email:_________________________________________________________ ITEM# DESCRIPTION QTY ITEM PRICE TOTAL PRICE MERCHANDISE TOTAL Shipping Charge (per address) *COLD PACK FEE $5 (if perishable) TOTAL 6.75% NC or 6.25% IL Sales Tax (shipping to NC or IL only) GRAND TOTAL DUE Ship to the following address Name ________________________________________________________ Address ________________________________________________________ City_____________________ State ______ Zip___________________ Phone (Required):________________________________________________ GIFT MESSAGE_________________________________________________ GIFT WRAP YES NO CREDIT CARD NUMBER EXPIRATION DATE SECURITY CODE Signature_____________________________________________ *All perishable food orders require a $5 COLD PACK FEE PERISHABLE FOOD SHIPPING REGIONS _____________ ORDER VALUE GROUND SHIPPING PERISHABLE 2ND DAY AIR PERISHABLE 2ND DAY AIR NEXT DAY AIR BLUE STATES 2-3 DAYS * ORANGE STATES 2-3 DAYS * ALASKA & HAWAII 3 DAYS * ANY STATE 1-2 DAYS * $0 to $150 $17 $45 $70 $85 $150.01 to $300 $34 $90 $140 $170 $300.01 and up 15% 36% 45% 50%