Hydrau-Tech, Inc. Software Order Form 

1.  SOLD TO:  2.  SHIP TO:
Name___________________________ Name___________________________
Address_________________________ Address_________________________
City____________________________ City____________________________
State__________Zip_______________ State___________Zip______________
Country_________________________ Country_________________________
Phone___________________________ Phone___________________________
Fax_____________________________ Fax_____________________________
Email___________________________ Email___________________________
 
3.  SOFTWARE PRODUCTS: 
 
PRODUCT PRICE (each) QUANTITY TOTAL PRICE
BRI-STARS $789    
GSTARS $589    
SedWin $349    
SedBase $499    
RView $149    
    Total Amount   
    Shipping Charge 
($10 for Standard,  
$25 for Express mail) 		  
    CO Add 7% Tax   
    GRAND TOTAL   
 
4.  PAYMENT METHOD: 
Enclose your money order, or credit card information as indicated as below. 
Card No.:___________________________Exp. Date:_______________
Signature:__________________________________________________
Paid by:   ___MasterCard   ___Visa    ___Money order 
 

Simply fill out the order form and send to (Fax or Mail) 
By Fax:     (970) 223-8484 
By Mail:    Hydrau-Tech, Inc. 
                 333 West Drake Road, Suite 40 
                 Fort Collins, CO 80526 

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