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Mail Order Form:
Riviera Building & Design, Inc.
154 Avenida Victoria
San Clemente, CA  92672
email:info@rivierabuilding.com

For Info Call:
949-366-6045 Phone
949-366-6048 Fax
9-5 Mon. - Fri. Pacific Time

 
NAME (Address info below)
DATE OF ORDER :
Item # Description Quantity Amount ($US) Total
         
         
         
    Sub-Total    
  California Residents Add 7.75% Sales Tax    
Shipping & Handling Charges    Shipping Rates average $3.95, call for specific charges - (949-366-6045), or we will add your shipping and email your shipping charges to the email address provided below.
    TOTAL    
Comments and Special Instructions:
Method of Payment:
Check or Money Order # Please make check payable to:  
Riviera Building & Design, Inc.
Credit Card Payment -
(Please circle one)		 Visa MasterCard Discover  
Credit Card Number: Exp. date: 3-digit code from back:
Signature: Daytime Phone :
Other Phone:
Shipping Address: Billing Address(if different from Shipping Address)
 
Email Address:
How did you hear about us/referred by:
Thank You for your Order !!