<p> Government Envision Business Cards Business Card Order Form 2050 S. Edwards | Wichita, KS 67213 Schedule # 75IIB Toll Free: 1.877.229.8466 Contract # GS-00F-0001K SIN J752-1 Fax: 316.440.6427 Please Type or Print Web: www.envisionbusinesscards.com A Contact Name: Tel: Date: Agency Name: Fax: E-mail: Shipping Contact & Address: </p><p>Orders ship UPS Ground or FedEx Ground unless other arrangements are made Payment Method Not all logos available in embossed gold foil – please call to confirm. Credit Card Number Expiration Date Style Selection A B C D E (A, B, C, D, E): Custom (add $30.00) Name of Template if Known: Print No. of Sides : 1 side 2 sides * Cardholder Name: (Provide sample for 2nd side) Logo: Signature of Cardholder Foil Printed Custom (Foil Styles A or B Only) Check/Money Color: Black Blue Order # Purchase Order # Quantity: 250 500 1000 (Minimum order value $50) Billing Address Braille/Custom/Overseas ($50 minimum) Shipping fee(s): Cost: Business Cards have 30% PCW / 50% Recycled which meets Federal Procurement guidelines. Instructions for Braille Cards Braille Option Braille text is limited to four lines of 13 characters each 250 Braille One Side $25.00 In using Braille there is no punctuation or capitalization 500 Braille One Side $50.00 Enter Braille info here: Sample: 1000 Braille One Side $100.00 1. john smith 2. dept of ed * Information for 2nd Side (or attach sheet if needed) 3. voc rehab 4. 202-222-2222 B Type or Print Information All caps, small caps, lowercase based on style selected. B Address Line 1: </p><p>Logo/Seal to appear on card 2nd logo (for Style D only) Address Line 2: (Attach Sample if possible) Address Line 3: Agency Heading: * (N/A for style C) State Cit Zi Subheading (if any): : y: 2 Letter p: Code Name: Telephone: </p><p>Title: Fax: Title Line 2 if needed: (on same line as Title for style C if space E-mail: permits) Division, Branch, Office, etc: Other (on same line as Title for style C if space permits) (specify): *U.S. Department of Justice Bureaus must have “U.S. Department of Justice” as the Main Agency as per the U.S. Department of Justice Graphic Standards Manual. For additional styles –call 1-800-799-0402 for more information. ** Information to appear on card back: We will match front of card. Attach separate sheet if needed. NOTE: Please review order forms before submission. Remake requests will be at full cost to the customer if due to unclear orders or customer error. We will honor all remake requests due to errors on our part if notified within 30 days of shipment. All email addresses set using lower case. All States set using 2 letter code. Cancelled orders subject to charge.</p><p>Govt Order Form 12.0708 dl 00bea4b9d63bfa830853ef0a1800e90a.doc 08/29/02</p>