Amzi! Order Form ========================================================================== INSTRUCTIONS All Amzi! products and updates can be downloaded from our web site, and are unlocked by entering the registration information we e-mail to you. Alternatively we can ship the products on 3.5" diskette for an additional shipping charge. Please note for diskette orders outside the U.S., customs charges or import duties may be applied by officials in your country. We accept MasterCard, Visa, Discover, American Express, purchase orders (from education, government, D&B-listed companies), wire transfers and checks or money orders in U.S. dollars drawn on a U.S. or Canadian bank. (Call Us for Multiple PC Licenses & Quantity Discounts) For Immediate Shipment-- FAX to: 513 / 425-8025 (anytime) or call: 513 / 425-8050 or e-mail: sales@amzi.com on Internet Or, Mail to-- Amzi! inc. 5861 Greentree Road Lebanon, OH 45036 U.S.A. ========================================================================== Bill To: Ship To (if different): Name (first last): Name (first last): Organization: Organization: Full Mailing Address: Full Mailing Address: Country: Country: Phone: FAX: E-Mail (required): -------------------------------------------------------------------------- # Item Price Each Total -------------------------------------------------------------------------- __ Amzi! Prolog+Logic Server, PC Professional Ed. US$ 598.00 ________ __ 1st Year PC Professional Subscription Plus US$ 198.00 ________ (Requires above) __ Amzi! Prolog+Logic Server, PC Personal Edition US$ 298.00 ________ __ 1st Year PC Personal Subscription Plus US$ 99.00 ________ (Requires above) __ Amzi! Prolog+Logic Server, PC Professional Edition 5-Developer Workgroup License (Includes licens for up to 5 developers and First Year Subscription Plus) US$ 2385.00 ________ __ Amzi! Prolog+Logic Server, Solaris Edition US$ 898.00 ________ __ 1st Year Solaris Subscription Plus US$ 298.00 ________ (Requires above) __ OPL, Object-oriented Programming with Logic US$ 149.00 ________ SUB-TOTAL ________ U.S. Ohio Residents add 6% Sales Tax ________ Shipping (Internet $0, All Others $20) ________ Subscription Plus Shipping (Internet $0, Diskettes $50) ________ TOTAL (all funds payable in U.S. $ please) ________ Payment Method: __Check (drawn on a U.S. bank) __Wire Transfer __MasterCard __Visa __American Express __Discover Card #: __________________________________________________________ Exp Date: __________ Issuing Bank: __________________________________________________________ Signature: __________________________________________________________ Please tell us where you learned about us... __an ad in_____________________ __an article in_________________ __a web site___________________ __a friend or associate __mail from____________________ __other_________________________ ========================================================================== 29 Apr 98