amsss1@americanasoftseats.com

                                                                      732-406-9508

Please include this Order Form in with the seat. See Below for Shipping Label.

Money Orders,Bank Checks,Personal Checks Accepted.  Please make payment out to 'J. Agostisi'

Name_______________________________________________________________

Address_____________________________________________________________

City ____________________State________________ ZIP____________________

 Email_______________________________________________________________

Height ______________    Weight _______________   Phone # _________________

Motorcycle     Year: _____________Make: _____________ Model: ______________

How did you hear about Americana Soft Seats?  Print Add______Web Search______   Customer Referral______Other______

                                                             Sale Prices

1" Thick Super Visco-Elastic Gel Memory Foam covered with 1/4"  Memory Foam - DRIVER SEAT 

$169 Sale price $149

1" Thick" Super Visco-elastic Gel Memory Foam covered with 1/4" Memory Foam. DRIVER and PASSENGER SEATS

$199 Sale price $179

1 " Thick Super Visco-elastic Gel Memory Foam covered with 1/4" Memory Foam. PASSENGER SEAT ONLY

$99

Aftermarket Seats  (Corbin, Mustang). 1 " Thick Super Visco-elastic Gel Memory Foam covered with 1/4" Memory Foam

$199 Sale price $179

Sub Total __________ ______
NJ residents. Sales Tax Multiply .06 _______
Shipping $26.95
Shipping Insurance (optional) $5.00
Total Price _______

SPECIAL INSTRUCTIONS:_______________________________________________________________________

DISCLAIMER. We guarantee all workmanship for a period of one year from your original order date. WE CANNOT GUARANTEE THAT A GEL PAD AND MEMORY FOAM INSTALLATION WILL SOLVE ALL YOUR RIDING DISCOMFORT. EVERY INDIVIDUAL IS BUILT DIFFERENTLY AND EVERY ONE WILL GET DIFFERENT RESULTS. All customers that agree into a purchasing agreement for our custom modifications agrees to this warranty and limitations of liability. We insure all parcels that we send with US Postal Service for $200. We do not accept responsibility if your parcel (seat) is lost once the Postal Service has it in their possession. Any customer that modifies or removes our Memory Foam nullifies all AMSSS Warrantees.

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Americana Soft Seats 
116 Brookview Cr.
Jamesburg, NJ 08831

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