Order Form

 Please complete the quanity, length of days you will need the items, the delivery location and the delivery / pickup dates.

	Quantity	Image	Product		Each Price	Total
			Graco Portable Crib		$19.00	$19.00
	Please select your rental length using the pull down menu. Each overnight or 24 hour period is considered a day rental. 1 Day 2 Day 3 Day 4 Day 5 Day 6 Day 7 Day 8 Day 9 Day 10 Day 11 Day 12 Day 13 Day 14 Day 15 Day 16 Day 17 Day 18 Day 19 Day 20 Day 21 Day Over 21 Days Rental. Call for prices 772-413-2552

I live outside the merchant's home state -- 7.00% I live in the merchant's home state -- 7.00% Please choose a delivery city Vero Beach, $25.00 Sebastian, Ft. Pierce $30.00 Port St. Lucie, Grant, Palm Bay $35.00 Melbourne, Satellite Beach, Stuart, Palm City $45.00 Cocoa Beach, Merritt Island, Cape Canaveral $60.00 Provide your delivery and pick-up dates in this text box.	Subtotal $19.00 Pick-up and Delivery $25.00 Taxable Amount $44.00 Sales Tax $3.08 Total $47.08

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