KOSCIELSKI'S & K.G.S. 2926 CHICAGO AVE, S. MPLS, MN. 55407
M-F 11-6PM SAT: 11-3pm

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                                            DURA-COAT ORDER FORM

      
Please copy and paste  in New Microsoft Word Document and print out. 

 

Please provide a good ship to address (No P.O. Boxes, or Rural Routes)

ORDER FORM ONLY

NAME_____________________________________

ADDRESS_________________________________

CITY______________________________________

STATE____________________________________

ZIP CODE_________________________________

E-MAIL___________________________________

PHONE___________________________________

 

HANDGUN UPPER: MAKE:_______________  MODEL_______________

1ST COLOR_______________________________$65.00

 

HANDGUN LOWER: MAKE:_________________  MODEL_______________SER#________________

1ST COLOR________________________________$65.00

 

Semi Auto Handgun Upper and Lower One Color. $  105.00

COLOR_________________________________________

 

Semi Auto Handgun Upper and Lower Two Color. $  105.00

1STUpper COLOR________________________________

2nd Lower COLOR_______________________________

 

Tiger Stripe Semi Auto Handgun Upper Slide Two Color Only. $95.00

1ST COLOR________________________________________

2nd COLOR________________________________________

 

Tiger Stripe Semi Auto Handgun Lower Receiver Two Color Only. $125.00

1ST COLOR__________________________

2ND COLOR___________________________

 

 

 Tiger Stripe Semi Auto Handgun Upper Slide and Lower Receiver Two Color $225.00

 

1ST COLOR_____________________________

2ND COLOR_____________________________

 

AR-15 Buttstock, Forend and Grip One Color  $135.00

Color__________________________________

 

AR-15 Buttstock, Forend and Grip "Tiger Stripe" Two Color $300.00

1st Color________________________________

2nd Color________________________________

 

PLEASE STRIP YOUR LOWER RECEIVER BEFORE SHIPPING

PLEASE PUT ANY PARTS IN A ZIP LOCK BAG, THAT YOU WISH TO DUAL-COAT.

 

Quantity

ITEM

Color

Total

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Sub Total

 

 

 

Shipping & Handling $:

 19.95

 

Only MN. Resident

Minn. sale tax  .0775%

 

 

 

Total $:  

 

 

PLEASE SEND CHECK OR MONEY ORDER ONLY.
IT WILL TAKE ANYWHERE FROM 4 TO 7 WEEKS.

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