US Customer þ		Canadian Customer  p
International  p
Quote		Order
Customer Name:
Customer Purchase Number:
Ship To:
Bill To:
Special Instructions:
Contact Name:
(must)
E-mail address:
(must)
Company:
(must)
Phone:
Fax:
Order Number:
Warehouse:
Ship Date (mm/dd/yy):
Delivery Date (mm/dd/yy):
Item Number	Description	Count		Number Case
	Junior Bubble Gum
02117	Juniors	5800
00948	Juniors Giants	3650
Item Number	Description	Count		Number of Case
	Mouth Full Bubble Gum
04873	Centuries	1900
04874	Jumbo Assorted	1430
04892	Bubble Brights	1430
04876	Soda Fountain	1430
04877	Smiles (Asstd. colors)	1080
04808	Ball of Fire	1080
04809	Baseball	1080
04854	Jumbo Assorted	1080
04855	Blots	1080
04810	Baseball Assorted	1080
05660	Green Apple	1080
05611	Black Cherry	1080
05662	Peaches N Cream	1080
05663	Wicked Watermelon	1080
Item Number	Description	Count		Number of Case
	Candies
00816	Super Sours (coated)	700
00825	Super Sours (Uncoated)	800
00876	Super Sweet (Coated)	13520
00890	Snaps (Uncoated)	11000
00891	Snaps (Coated)	11000
00892	Smiles (Uncoated)	8250
04008	Lotsa Sours (Coated)	6200
04053	Sweet Revenge (Coated)	1040
04084	Lil Jewels (Coated)	80000
04290	Nitwitz	621
04291	Banana Heads	725
04292	Kooky Bananas	725
Item Number	Description	Count		Number of Case
	Colossal Bubble Gum
03998	Peaches N' Cream	850
03999	Cinnamon Apple	850
04001	Strawberry Shortcake	850
04024	Wicked Watermelon	850
04055	Beach Ball	850
04056	Soda Fountain	850
04058	Fruit Stand	850
04076	Green Apple	850
04089	Beach Time	850
04115	Ice Cream Sundae	850
04116	Blots	850
04119	Smiles	850
04229	Half & Half	850
04260	Black Cherry	850
04817	Spooky Eyes	850
04864	Baseball	850
04865	Assorted	850
04866	Grape	850
04890	Bubble Brights	850
04898	Thunderbolts (Filled)	850
04017	Assorted	700
Item Number	Description	Count		Number of Case
	Chicle Gum
01143	Chicle Tabs	9900
04061	Chicle Tabs	12900
04063	Frost Bites	9900
04064	Zig Zags	9900
04065	Zips	9900
09131	Tabbylets	22900
81411	Refresh	9900
Item Number	Description	Count		Number of Case
	Novelty Bubble Gum
04113	Hockey Pucks	4300
04121	Jelly Beans	5500
04170	Mouth Full (Filled)	138
04171	Mouth Full (Unfilled)	138
04226	Mega Eggs	140
04227	Groovy Fruit	850
04730	Little Sputters	5800
04932	Spinning Tops	1600
04280	Sparklers	850
04281	Fruit Shakers	850
Item Number	Description	Count		Case
	Jawbreakers
03997	Timebomb (Candy center)	850
04140	Boulders 1 1/4" (Gum center)	400
04150	Boulders 1 3/4" (Gum center)	144
04160	Boulders 1 1/4" (Gum center)	85
04228	Buzzards (Gum center)	600
04721	Black Balls (Gum center)	850
04722	Red Hots (Gum center)	1600
Item Number	Description	Count		Number of Case
	Promotional Items
04009	Winner Gumballs	900
04059	Special Assorted	850
Item Number	Description	Count		Number of Case
	Titans Bubble Gum
04896	Thunderbolts (filled)	600
04003	Cinnamon Apple	600
04025	Peaches N' Cream	600
04812	Assorted	600
Item Number	Description	Count		Number Case
	Peg Bags
12335	Bubble Brats 6.5 OZ.	12
12336	Shivers 6.5 OZ.	12
Item Number	Description	Count		Number Case
	Lay Down Bags
12312	Bubble Brats 9.0 OZ.	24
12313	Blots 9.0 OZ.	24
12314	Shivers 9.0 OZ.	24
12315	Mixed Case (Halloween Only)	24
Item Number	Description	Count		Number Case
	Jars
75000	Bubble Brats 200 PCS.	4
75005	Blots 200 PCS.	4
75030	Shivers 200 PCS.	4
75050	Baseball 200 PCS.	4
Questions or comments:

- MS Excel version of this form can be downloaded from  here: US / International  Customers / Canadian Customers

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