ORDER FORM

CAPSTAN     Rope Winch

MAIL ORDER TO: TELEPHONE ORDERS
SIMPSON WINCH INC.
P.O. BOX 91553
PORTLAND, OR 97291-0553
TOLL FREE:
1-800-762-4450
FAX (503) 222-7720

Prices effective June 1, 2010.  Subject to change without notice.  All prices are in US dollars.

MODEL DESCRIPTION RETAIL QUAN TOTAL
SP-CW With Honda 4 Stroke Engine $849.00    
CS-CW Fits Chain Saws With 3/8" Pitch Chain $599.00    
  LOW STRECH ROPE      
ROPE 3/8" X 300'     3 Strand Twisted Polyester $159.00    
ROPE 3/8" X 600'     3 Strand Twisted Polyester $210.00    
ROPE 3/8" X 300'     Double Braid Polyester $185.00    
ROPE 3/8" X 600'     Double Braid Polyester $240.00    
  Shipping & Handling UPS or USPS      
Total Amount Enclosed  

Method of Payment:   Check/Money Order enclosed______    Charge to my credit card______

Visa Card #_________________________________   Exp. Date_____________

Master Card #_________________________________   Exp. Date_____________

SOLD TO: SHIP TO: (NOT A P.O. BOX)
Name:       ____________________________

Address:    ____________________________

               ____________________________

Telephone:_(_____)_____________________
Name:       ____________________________

Address:    ____________________________

               ____________________________

Telephone:_(_____)_____________________