1. $10 delivery charge will be applied for orders under 6 bottles
ORDER FORM
Great Wines from Deep in the Cellar---April 26, 2016
Delivery Instructions
Brokers & Consultants
of Fine Wine
Sold to
Please provide 9-5 address
Phone #
*** Address
QTY
WINE
PRICE PER
PRICE PER CASE
2011 Chateau St Jean Robert Young Vineyard Chardonnay
$26.00
$23.40
2009 Montevetrano Colli di Salerno
$57.50
$51.75
2011 Decero Petit Verdot
$29.00
$26.10
2013 Gaja Sito Moresco
$49.50
$44.55
2013 K Vintners Motor City Kitty Syrah
$36.00
$32.40
$10 delivery charge will be applied for orders under 6 bottles
Credit Card #
Wines fullfilled by:
Dallas Fine Wines
3518 Oak Lawn Ave
Dallas TX 75219
Can pick up wines at store during their normal business hours
Expiration
Security Code
Billing Address