ENGINE ORDER BLANK  (Please print this order blank and mail  with deposit)

 NAME: __________________________________________________ MAKE OF CAR: ____________________

ADD: ____________________________________________________ YEAR: ____________ 

          ____________________________________________________ ENG. TYPE: ____________

CITY: ____________________________ STATE: ________ ZIP: ___________          DAYTIME PH # _____________

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ENGINE DESCRIPTION:  STAGE: _____________ ASM/KIT: ___________  ENGINE PRICE $______________ =======================================================================================

NO.ITEMS         DESCRIPTION OF EXTRA PART OR WORK ITEM                     PRICE/EA     EXTENDED PRICE

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______     _________________________________________________________ $________    $______________

______     _________________________________________________________ $________    $______________

 ______     ________________________________________________________ $________     $______________

 ______     ________________________________________________________ $________     $______________

 ______     ________________________________________________________ $________     $______________

______      ________________________________________________________ $________     $______________

______      ________________________________________________________ $________     $______________

                                                                                     TOTAL PRICE OF ENGINE AND PARTS $______________ =======================================================================================        

                                                         ADD A $200.00 CRATING CHARGE (if engine is to be shipped) $______________

                                                                        ADD CORE CHARGE (if you are not sending in a core) $______________

                                                                                                                 TOTAL PRICE OF ORDER $______________

SUBTRACT DISCOUNTS  (10% for off-season discount --- 5% if paying in full) ---------------------- $______________

                                  (TOTAL AMOUNT OF ORDER AFTER FULL PREPAYMENT DISCOUNT $______________ ======================================================================================

 Engine Core Information CHECK APPROPRIATE LINE:

     1. Outright (no trade-in):  _____     2 .Build on your core   _____     3 .Build on PAECO core and exchange   _____ ======================================================================================

    In placing this order, I understand that there is a 90 day warranty on assembled engines, but there is no warranty on kit engines. Any litigation involving this contract shall be governed by the laws of the state of Alabama and shall be tried in an Alabama court. In the event of non-payment, I agree to pay the costs of collection, including a reasonable attorney's fee. I have read and understood the PAECO engine warranty.

 SIGNED: ________________________________________________ DATE: _______________