1 219 326 8880 Figment Group Inc.

Lifeloc Equipment and Supply Order Form

Shipping & Handling Charges will be added to your total purchase.

Please complete the order form completely.

To select an item, choose your quantity.

To submit your order, please click on the Captcha—–I am not a robot box, then click the Submit Order button at the bottom of the form.

For equipment and supplies not listed on this order form, please contact Figment Group, Inc. at 219.326.8880 or by E-mail.

 

Mouthpieces

Part No. 13043 - List: $24.60/pkg
Part No. 13046 - List: $58.45/pkg

Forms

Part No. 14010 - List: $27.30/pkg
Part No. 14008 - List: $27.30/pkg

Printer Labels

Part No. 14107 - List: $25.45/roll
Part No. 14197 - List: $83.95/roll

Bluing Tablets

Part No. 19003 - List: $14.29/bottle
Part No. 19064 - List: $37.86/3-pk

Dry Gas

Part No. 15011 - List: $141.00/cyl
Part No. 15005 - List: $141.00/cyl

Calibration Supplies – Adapter & Regulator

Part No. 15308 - List: $5.15/kit
Part No. 15302 - List: $115.50/unit

Cables & Chargers

Part No. 17005 - List: $68.00/unit
Part No. 17102 - List: $196.00/unit
Part No. 17203 - List: $85.00/unit
Part No. 17206 - List: $87.60/unit
Part No. 17204 - List: $60.75/unit
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