| Go Live Inc 5418 West Crenshaw St Tampa, FL 33634 |
CD |
To Place An Order By Phone, Please Call TOLL FREE: 1-800-430-2982 Monday - Friday 8am - 5pm EST Fax: 1-(813) 885-4407 |
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All orders
are Shipped in a Plain Box, with NO Mention of the Word Condoms
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| Ship To: | Bill To: | |||||||
| Name | . | Name | . | |||||
| Address: | . | Address: | . | |||||
| . | . | . | ||||||
| City | . | City | . | |||||
| State | . | Zip | . | State | . | Zip | . | |
| Email Address: We will email you confirmation that we received your order. We will not sell or share your email address. |
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quantity: |
Item Name: ..... Example 12 Pack Durex Extra Sensitive |
Price
Each |
Total |
| . | . | $ | $ |
| . | . | $ | $ |
| . | . | $ | $ |
| . | . | $ | $ |
| . | . | $ | $ |
| . | . | $ | $ |
| . | . | $ | $ |
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Plain
Box Shipping: ( Free Shipping 5-10 Days/ $0 -or- Priority Mail 2-3 Days/
$4.99) |
$ | ||
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FL
Residents Only - add 7% Sales Tax |
$ | ||
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Total |
$ | ||
| Payment Options: | If
your are paying by Check or Money Order: Please Make Payable to Go Live Inc. and send to: Go Live Inc 5418 West Crenshaw St Tampa, FL 33634 Pay with Money Order For Same Day Shipping. Money Orders are Available at the Local Post Office * Note: There is a $25 Fee for Bounced Checkes, Personal Check are held for 10 days. |
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| Credit Card: ( Visa MasterCard American Express Discover ) Money Order Check* | ||
| Card Number: | 3 Digit CCV Code ________ The last 3 digits on the back of your credit card where you sign your name |
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| Expiration Date: | ||
| Card Holder Signature: X___________________________________________ | ||