Purchase Order

Billing Information

Name of whom do you want us to issue the invoice:

Phone

Address of whom do you want us to issue the invoice:

City

State/Province

Zip/Postal

What was the amount of bentonite quoted for your pond?

What was the estimated freight cost that we quoted you?

Quote's
Number

Taxation

Are you or your company base in Texas?

Yes, I'm base in Texas

No, I'm not

Do you have a Tax exempt permit in Texas

Yes, I have a tax exempt permit in Texas

No, I don't have a permit

If you are Tax Exempt, please download the form that applies to your case, fill it out, sign it and upload it.

Texas Agricultural
Texas Tax Exempt Form

Upload picture of your tax permit

Maximum file size: 150MB

Delivery Information

Is your delivery and billing address the same?

yes, are the same

Complete delivery address (if different than the invoice)

City

State/Province

Zip/Postal

Person in charge of unloading

Name of the person in charge of unloading

Phone of the person in charge of unloading

Delivery location days and hours of operation

Do you have a drooped pin location you can share for the driver or GPS coordinates?

Yes

Please attach any further delivery instructions, such as GPS coordinates, a pinned location, or any other pertinent information

please specify the day you want your order delivered

*We'll do our best to get your order delivered on the requested day and time, and we'll keep you updated as your truck is loaded and on its way, but we can't promise the delivery time or date because it depends on the availability of our carriers' trucks and drivers. We usually require a delivery window from 9:00 a.m. to 5:00 p.m. on the day we arrange delivery for you.

Confirm that you have equipment to unload 3,000 lbs. super sacks from flatbed truck

Yes

Please note that you will need equipment to unload super sacks from an eighteen-wheeler flatbed truck. (please check the attached sample pictures on how to unload super sacks)

Require wooden pallets?

Yes

Super bags will not have a wood pallet underneath. * It is only available upon customer request, and each wood pallet has a cost of $27.00.

Pallet Quantity?

Payment Information

You can either pay after receiving your invoice by signing the attached credit card authorization form, by calling us with your credit card number, or direct deposit to our business bank account

Download Credit Card authorization form
LoneStar Bank Account Information

Attache your signed CC authorization form

Maximum file size: 150MB

Comments

Once your order is processed and your truck is scheduled for pick up, loaded, and ready to go, we'll give you an anticipated delivery date and time.

Please let us know if you need additional information or your comments

If you are human, leave this field blank.