WATER DELIVERY ORDER FORM

Please read before placing your order. *

We have a minimum order volume of 4 bottles per order within Winnipeg to keep our delivery running as efficiently for clients as possible. This is a combination of any 4 bottle sizes on this form. (eg: three 5-gallon bottles & one 3-gallon bottle or four 5-gallon bottles). Our friendly drivers will deliver your order six days a week, Monday to Saturday, on a call today - deliver tomorrow basis. For orders outside the Perimeter Hwy., the minimum order is between 5 and 10 bottles. Please verify initially by calling our office. For your convenience, you do not have to be present at your home or office to accept the water delivery. Simply leave your empty jugs out for us wherever you would like the full ones left. If you will be present at the time of delivery - keep your empties inside. Our driver will be more than happy to carry the bottles inside your home or office and remove the used ones. To arrange for a delivery, please fill out the contact form below or call our office at 204-889-2837 and one of our staff will be happy to take your order over the phone. If you are calling after hours, please leave your full contact details on our answering machine and your order will be delivered that business day.

I have read the above.

Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Method of payment *

Cash

Cheque

Credit card on file

One litre bottles - Twelve pack

Cases of 12 one litre bottles

One case (12 one litre bottles) - $30

Two cases (24 one litre bottles) - $60

Three cases (36 one litre bottles) - $90

Four cases (48 one litre bottles) - $120

No, not at this time.

One litre bottles - Six pack

Cases of 6 one litre bottles

One case (6 one litre bottles) - $16

Two cases (12 one litre bottles) - $32

Three cases (18 one litre bottles) - $48

Four cases (24 one litre bottles) - $64

No, not at this time.