Order Form Name of the Purchaser:____________________________________________ Address: ________________________________________________________ City: _______________________ State/Prov: ________________________ Zip/Postal Code: ___________________ Country: ____________________ Tel: ___________________________ Fax: ____________________________ E-mail : _________________________________________________________ To - SPJ Systems 101, Beaver Grandeur, Baner Road Pune - 411 045 (INDIA) Fax: +91-20-7293003 We are pleased to place our purchase order on you as follows: (Please keep only the required product(s) and delete others. Also write quantity and amount and total of amounts) No. Item Code and Description Price Qty. Amount (US$) 1 SIM85: Simulator for 8085 US$ 49.95 (for DOS) 2 SIM51: Simulator for 8051 US$ 49.95 (for DOS) 3 WSIM51: Simulator for 8051 US$ 69.95 (for Windows9x/NT/2000/ME/XP) 4 WSIM85: Simulator for 8085 US$ 69.95 (for Windows9x/NT/2000/ME/XP) 5 SC51: C Compiler for 8051 US$ 225.00 (includes compiler, assembler, linker, IDE, simulator) (for Windows9x/NT/2000/ME/XP) 6 C-AVR: C Compiler for AVR US$ 225.00 family of micro-controllers 7 C-AVR-N: C Compiler for AVR US$ 149.00 family of micro-controllers (non-mega) Add Shipping Charges 50.00 Total Please accept the total payment of US$ _______ by MasterCard / Visa. (Please rub-out whatever is not applicable) Name of the Card Holder : _______________________________ Date of birth(dd/mm/yyyy): __ __ ____ Card number : ____ ____ ____ ____ Card expiry date(mm/yyyy): __ ____ OR Enclosed please find a Cheque / Demand Draft no._____________ drawn in favour of SPJ Systems for the amount US$ _______ OR We have sent the entire payment of U.S.$ _______ to your bank account via our bank __________ on dd/mm/yyyy. (Please print only one of the above three) Date: _________________ Signed: _______________________________ Acknowledgement (Please print, sign and fax us this part only after you receive the ordered software by UPS / by e-mail.) Name of the Purchaser:________________________________________ (Please write the same name as you wrote in the order form) Name of the Card Holder : _______________________________ (Please write the same name as you wrote in the order form, only if you ordered the software using credit card. In case of other modes of payment, leave it blank.) I / We have received the ordered software by UPS / by e-mail in good order. Thank you. Date: _________________ Signed: _______________________________ (by the Purchaser) (If the purchaser is a company / organization, please also imprint the company / organization's stamp.) Signed: _______________________________ (by the Card Holder) (Only if you ordered the software using credit card)