RACER Software Order Form

RACER® – Software Order Form

SHIP TO Name Title Organization Address City, State Zip Phone Number Fax Number Email Address

ORDER DETAILS QTY PRODUCT PRICE (PER PRODUCT) SUBTOTAL

Preferred Delivery Method: Download CD (Shipping Fee Applies) Shipping (if CD Selected, Fee is per Location): US Mail ($10.00) Fed Ex Overnight ($30.00) Total Shipping Charges (No Shipping Fee if Software Downloaded): Sales Tax* (if your organization is sales tax exempt, please include documentation with your order): Order Total*:

METHOD OF PAYMENT

Method of Payment: Visa MasterCard

Please complete page 2 of this form and return with your order.

Purchase Order

Please include purchase order document with your order submittal.

* Please Note: Sales tax subject to verification based on shipping location(s) and state taxation laws.

ALL SALES ARE FINAL.

Return completed form to AECOM: Email: [email protected] Mail: AECOM – RACER 6200 S. Quebec Street Greenwood Village, CO 80111 Banking & GL Group Credit Card Processing Form

Please verify form is filled out completely and legible and return to AECOM with your order for processing. Thank you.

1) Amount of Payment:

2) Credit Card Type:

3) Credit Card Number:

4) Expiration Date:

5) Individual's Name on Credit Card:

6) Company’s Name:

7) Phone Number:

8) Street Address

9) City, State Zip:

10) Cardholder Signature:

AECOM Use Only:

Invoice Number Being Paid:

AECOM Project Manager Name:

Project Number:

Task Number and/or Subtask:

AECOM Requestor: