Blue Diamond Secure Order Page

Blue Diamond Secure On-Line Store

This is an order form you can print out. Please call Blue Diamond at 1-877-632-5833 to order.

Enter quantities below. If you need help in deciding what to order, Click here.		FAQ'S
Product Description			Total
UV 102 Complete System	$1,457.50 (USD)
UV 202 Complete System	$1,815.00 (USD)
UV 202A Complete System	$2,018.50 (USD)
Exercise Pool System	$1,859.00 (USD)
Diffuser Stone	$18.27 (USD)
Filter Element	$159.07 (USD)
Filter Assembly	$186.30 (USD)
UV Lamp	$73.45 (USD)
UV Lamp Assembly	$213.84 (USD)
Air Pump Assembly	$188.89 (USD)
		Shipping and Handling
		Total

Billing Information
Name:*		Please enter your credit card billing address exactly as it appears on your credit card statement. Your billing address and phone number must match your credit card statement or we will not be able to ship your order until your billing address has been verified.
Company:
Address One:*
Address Two:
City:*
State:*	Overseas orders use OS
Zip/Postal Code:*			Country:
Shipping Information
My shipping address is the same as my billing address.
Name:*
Company:
Address One:*
Address Two:
City:*
State:*	Overseas orders use OS
Zip/Postal Code:*			Country:
Additional Information
Email Address:*	i.e. user@domain.com
Phone number:*	( ) - Ext:
Source:
* Required Entries!
Enter any additional comments for this order below.
Payment Information
Credit Card: *
Credit card number: *	(no spaces or dashes)
Expiration Date: *
Security Code: * (The 3 or 4 digit number on your credit card.) Discover, Mastercard and Visa use a 3 digit number on the back. Amex uses a 4 digit number on the front.
* Required Entries!