| Name __________________________________________________________________ | |
| Address ________________________________________________________________ | |
| City ____________________________ | State ______________________________ |
| Zip Code ________________________ | Phone _____________________________ |
| Please send |
| ______ Spill Stopping Device(s) @ $6.00 = ___________ |
| Shipping and Handling @ $1.50 per unit = __________ |
| TOTAL ___________ |
| Enclosed is my Check or Money Order for $ _________________ |
| Payable to The D.J. Snyder Company |
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