Our Coffee Barn

N8346 County Road I

Spring Valley, WI 54767

http://ourcoffeebarn.com

customerservice@ourcoffeebarn.com

Phone 877-265-2652

Fax 877-282-6275      

Ship To____________________________________ Billing Name_______________________________

Address___________________________________ Billing Address____________________________

__________________________________________ ___________________________________________

E-mail ____________________________________ Billing Phone_______________________________

Quantity

Item/Description

Price Per

Subtotal

Subtotal _____________

WI residents please add 5.5% tax on all items other than beans _____________

We will calculate shipping charges once we have your subtotal _____________

We will then notify you of your total and collect payment before processing TOTAL ____________

Payment method: □Check or Money Order (Your order will ship once payment is received)

□American Express □Discover □MasterCard □Visa

Card#___________________________________________ Expiration Date__________________

Address on card if different from above__________________________________________________

The most efficient way to order is on our safe and secure internet store which is SSL encrypted; however, orders may be placed by mail, phone or fax using this order form. Please contact us for current prices, shipping costs and available colors on equipment. Thank you.