Electric Supply - Orders Page Goldsboro Location

Electric Supply Company of North Carolina

Goldsboro Location Order Form

(*) denotes required fields

Purchase Order #:

Customer Name

Ship To

*Company Name:
*Address:
*City:
*State:
*Zip:
*Phone:
Fax:
*Contact:
*E-Mail:

Name:
Address:
City:
State:
Zip:
Phone:
Contact:

Comments, Delivery Instructions, Other Information: Order Detail:
	*Qty	*Unit of Measure	*Description
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Please call our Goldsboro location at (800) 849-2010 or (919) 734-1144 if you have any questions about this form or your order.

If you need more than 20 lines, please submit this order and the confirmation page will provide a link back to this form for additional items to be added.

Electric Supply Company
(800) 849-2010 or (919) 734-1144
501 North James St.
Goldsboro, NC 27530