Pure & Clean Supplemental Classroom Units

Your Name *

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Last

Best Phone Number To Reach You At: *

Your Email: *

Franchise/Distributor Number: *

APBids.com Approval Number: *

Enter the approval number for the bid you registered on apbids.com

Order Type

This is for a new order fulfilled after 9/15/21
This is to supplement a previously fulfilled order prior to 9/15/21

Original Sales Order Number You Placed For This School's Product

If you placed multiple sales orders for this school under this bid enter them separated by commas.

Number of units you wish to order. $120.00/ea USA $150.00/ea CAN

Please note, the number of units cannot exceed the total number of units originally purchased for this school's classrooms. *If you have other bids for this school please submit them separately.

Number of units you wish to order. $200.00/ea USA $250.00/ea CAN

Please note, the number of units cannot exceed the total number of units originally purchased for this school's classrooms. *If you have other bids for this school please submit them separately.

School Ship To Name & Address: *

Address Line 1

Address Line 2

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Zip Code

Note all orders on this program must be shipped direct to the school. Please advise the school accordingly.

Order Acknowledgement *

Acknowledged and Agreed

I authorize Aerus Franchising LLC to charge my ACH account or credit card on file to pay for the number of units being purchased outside the FOAS/ASIST system. I understand shipping charges if applicable will be calculated and added to the order.