® ORDER FORM 2023 PROMOS COMPANY NAME: ADDRESS: ADDRESS: PHONE: CONTACT NAME: DISTRIBUTOR INFO EMAIL: COMPANY NAME: ADDRESS: ADDRESS: PHONE: CONTACT NAME: CUSTOMER INFO EMAIL: Product # 1012020 1021691 1012021 1048702 *11315 *FREE* 5 SQWINCHER® SQUEEZE BOTTLES - PURCHASE 1 CASE QWIK STIK® Descripton QTY Qwik Stik® Lite Single Serve Orange (Case contains: 10 bags of 50 Stiks, 500 Stiks per case) Qwik Stik® Lite Single Serve Mixed Berry (Case contains: 10 bags of 50 Stiks, 500 Stiks per case) Qwik Stik® Lite Single Serve Fruit Punch (Case contains: 10 bags of 50 Stiks, 500 Stiks per case) Qwik Stik® Lite Single Serve Strawberry-Lemonade (Case contains: 10 bags of 50 Stiks, 500 Stiks per case) Sqwincher® Squeeze Bottle (*Note this is Sqwincher Product # not Fastenal) *FREE* ONE 5 GALLON COOLER OR TWO 2 GALLON COOLERS - PURCHASE 15 CASES 64 oz. CONCENTRATE Product # Descripton QTY 1012023 Fruit Punch - ZERO Formula (No sugar), 64 oz./1.89L - Yields 5 Gallon (Case contains: 6 bottles per case) 1012024 Lemon-Lime - ZERO Formula (No sugar), 64 oz./1.89L - Yields 5 Gallon (Case contains: 6 bottles per case) 1012026 Orange - ZERO Formula (No sugar), 64 oz./1.89L - Yields 5 Gallon (Case contains: 6 bottles per case) 1008829 Lemonade - Regular Formula, 64 oz./1.89L - Yields 5 Gallon (Case contains: 6 bottles per case) 1008830 Orange - Regular Formula, 64 oz./1.89L - Yields 5 Gallon (Case contains: 6 bottles per case) 1008831 Fruit Punch - Regular Formula, 64 oz./1.89L - Yields 5 Gallon (Case contains: 6 bottles per case) 1008832 Lemon-Lime - Regular Formula, 64 oz./1.89L - Yields 5 Gallon (Case contains: 6 bottles per case) 1008833 Tropical Cooler - Regular Formula, 64 oz./1.89L - Yields 5 Gallon (Case contains: 6 bottles per case) 1008834 Grape - Regular Formula, 64 oz./1.89L - Yields 5 Gallon (Case contains: 6 bottles per case) 922491119 Mixed Berry - Regular Formula, 64 oz./1.89L - Yields 5 Gallon (Case contains: 6 bottles per case) *11336 Sqwincher® Cooler - 1 Gallon (*Note this is Sqwincher Product # not Fastenal) *11338 Sqwincher® Cooler - 5 Gallon (*Note this is Sqwincher Product # not Fastenal) Product # 1012028 *11902 *FREE* SQWEEZE® POP FREEZER- PURCHASE 46 CASES SQWEEZE® POPS Descripton QTY Sqwincher® Sqweeze® Pops (Case contains: 15 Packs of 10 assorted flavour pops, 150 pops per case) Sqwincher® Sqweeze® Pop Freezer (*Note this is Sqwincher Product # not Fastenal) PLEASE EMAIL THE COMPLETED FORM TO: dentec@dentecsafety.com
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