訂購單 | Costco 好市多線上購物

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傳真訂購單Fax Order Form

會員號碼
Membership Number

日期
Date

會員姓名
Name

統一編號
TAX No

聯絡電話
TEL

傳真號碼
FAX

收貨人
Consignee

送貨地址
Delivery Address

配送日期
Delivery Date

取貨方式
Pick-up Method

商品編號
Item No.

商品名稱
Description

數量
Qty.

單價
Unit Price

總計 / TOTAL

付款方式
Method of Payment

(1) 以信用卡方式付款 Pay By Credit Card

信用卡卡號
Credit Card No.

有效期限
Ex. Date

消費金額
Amount N.T. Dollar

持卡人姓名
Card Holder's Name

持卡人簽名
Authorized Signature

※依據「食品安全衛生管理法」第九條以及「應建立食品追溯追蹤系統之食品業者」之規定，請據實告知本訂單購買用途為： (必勾選)
According to Article 9 of the "Act Governing Food Safety and Sanitation" and "Food Businesses Shall Establish Traceability System of Food Products", please tell us about your purpose of this order: (*Required*)

*請勿使用email傳送信用卡資料，請以傳真方式提供。

Do not submit credit card detail via email, please provide by fax

*信用卡持卡人須與Costco會員卡持卡人為同一人
The credit card holder must be the same person as the Costco membership cardholder
*持卡人同意依照信用卡使用規定，一經使用或訂購物品，均應按照所指示之全部金額付款於發卡銀行。
The issuer of the card identified on this form is authorized to pay the amount shown as total upon proper presentation.
I promise to pay such total (together with any other charges due thereon) subject to and in accordance with the agreement governing the use of such card.

(2) 付現或電匯 / Via Cash or Via Electronic Transfer

北投店商業配送中心
銀行：兆豐國際商業銀行　蘭雅分行

（銀行代號：017）
抬頭：好市多股份有限公司北投分公司
帳號：01009036900
匯款完請將憑證傳真至(02) 7715-9781
Beitou Warehouse
Name of Bank：Mega International
Commercial Bank Co., Ltd., LanYa Branch
Name of Account：Costco Beitou Branch
Account No.：(017)01009036900
After remitting, please fax your remittance receipt to (02) 7715-9781

內湖店商業配送中心
銀行：兆豐國際商業銀行東內湖分行

（銀行代號：017）
抬頭：好市多股份有限公司內湖分公司
帳號：06709002399
匯款完請將憑證傳真至(02) 8792-1471
Neihu Warehouse
Name of Bank：Mega International
Commercial Bank Co., Ltd., East NeiHu Branch
Name of Account：Costco Neihu Branch
Account No.：(017)06709002399
After remitting, please fax your remittance receipt to (02) 8792-1471

汐止店商業配送中心
銀行：兆豐國際商業銀行南港分行

（銀行代號：017）
抬頭：好市多股份有限公司汐止分公司
帳號：07409006780
匯款完請將憑證傳真至(02) 2641-0877
Shihchih Warehouse
Name of Bank：Mega International
Commercial Bank Co., Ltd., Nan Gang Branch
Name of Account：Costco Shihchih Branch
Account No.：(017)07409006780
After remitting, please fax your remittance receipt to (02) 2641-0877

中和店商業配送中心
銀行：彰化銀行中和分行

（銀行代號：009）
抬頭：好市多股份有限公司中和分公司
帳號：56470108289900
匯款完請將憑證傳真至(02) 2246-1917
Chungho Warehouse
Name of Bank：Chang Hwa Bank
Commercial Bank Co., Ltd., Chungho Branch
Name of Account：Costco Chungho Branch
Account No.：(009)56470108289900
After remitting, please fax your remittance receipt to (02) 2246-1917

新莊店商業配送中心
銀行：兆豐國際商業銀行思源分行

（銀行代號：017）
抬頭：好市多股份有限公司新莊分公司
帳號：23509018006
匯款完請將憑證傳真至(02) 7729-1321
Sinjhuang Warehouse
Name of Bank：Mega International
Commercial Bank Co., Ltd., SheYuan Branch
Name of Account：Costco Sinjhuang Branch
Account No.：(017)23509018006
After remitting, please fax your remittance receipt to (02) 7729-1321

桃園南崁店商業配送中心
銀行：兆豐國際商業銀行南崁分行

（銀行代號 : 017）
抬頭：好市多股份有限公司桃園分公司
帳號：08009010788
匯款完請先將憑證傳真至(03) 270-6881
Taoyuan Warehouse
Name of Bank：Mega International
Commercial Bank Co., Ltd. Nan Kan Branch
Name of Account：Costco Taoyuan Branch
Account No. : (017)08009010788
After remitting, please fax your remittance receipt to (03) 270-6881

桃園中壢店商業配送中心
銀行：兆豐國際商業銀行中壢分行

（銀行代號 : 017）
抬頭：好市多股份有限公司中壢分公司
帳號：03909012399
匯款完請先將憑證傳真至(03) 271-2552
Chungli Warehouse
Name of Bank：Mega International
Commercial Bank Co., Ltd. Chungli Branch
Name of Account：Costco Chungli Branch
Account No. : (017)03909012399
After remitting, please fax your remittance receipt to (03) 271-2552

新竹店商業配送中心
銀行：兆豐國際商業銀行竹北分行

（銀行代號 : 017）
抬頭：好市多股份有限公司新竹分公司
帳號：20809022298
匯款完請將憑證傳真至(03) 563-1212
Hsinchu Warehouse
Name of Bank：Mega International
Commercial Bank Co., Ltd., Chupei Branch
Name of Account：Costco Hsinchu Branch
Account No.：(017)20809022298
After remitting, please fax your remittance receipt to (03) 563-1212

台中店商業配送中心
銀行：兆豐國際商業銀行中台中分行

（銀行代號 : 017）
抬頭：好市多股份有限公司台中分公司
帳號：20409804796
匯款完請將憑證傳真至(04) 3704-2799
Taichung Warehouse
Name of Bank：Mega International
Commercial Bank Co., Ltd., Central Taichung branch
Name of Account：Costco Taichung Branch
Account No.：(017)20409804796
After remitting, please fax your remittance receipt to (04) 3704-2799

嘉義店商業配送中心
銀行：兆豐國際商業銀行嘉義分行

（銀行代號 : 017）
抬頭：好市多股份有限公司嘉義分公司
帳號：02201037789
匯款完請將憑證傳真至(05) 320-0670
Chiayi Warehouse
Name of Bank：Mega International
Commercial Bank Co., Ltd., Chiayi Branch
Name of Account：Costco Chiayi Branch
Account No.：02201037789
After remitting, please fax your remittance receipt to (05) 320-0670

台南店商業配送中心
銀行：兆豐國際商業銀行府城分行

（銀行代號 : 017）
抬頭：好市多股份有限公司台南分公司
帳號：00609123788
匯款完請將憑證傳真至(06) 700-0566
Tainan Warehouse
Name of Bank：Mega International
Commercial Bank Co., Ltd. Fucheng Branch
Name of Account：Costco Tainan Branch
Account No.：(017)00609123788
After remitting, please fax your remittance receipt to (06) 700-0566

北高雄大順店商業配送中心
銀行：兆豐國際商業銀行港都分行

（銀行代號 : 017）
抬頭：好市多股份有限公司大順分公司
帳號：00209025678
匯款完請將憑證傳真至(07) 975-8871
North Kaohsiung (Dashun) Warehouse
Name of Bank：Mega International
Commercial Bank Co., Ltd., Kaohsiung Metropolitan Branch
Name of Account：Costco Dashun Branch
Account No.：00209025678
After remitting, please fax your remittance receipt to (07) 975-8871

高雄店商業配送中心
銀行：兆豐國際商業銀行港都分行

（銀行代號 : 017）
抬頭：好市多股份有限公司
帳號：00209011308
匯款完請將憑證傳真至(07) 536-3608
Kaohsiung Warehouse
Name of Bank：Mega International
Commercial Bank Co., Ltd., Kaohsiung Metropolitan Branch
Name of Account：Costco Kaohsiung Branch
Account No.：00209011308
After remitting, please fax your remittance receipt to (07) 536-3608

備註 / NOTE

型錄上所有品項資訊及商品圖片僅供參考，實際品項、包裝與數量以賣場為準。The pictures are for reference only, please contact warehouse for more details.
上列報價為會員價且已含5%營業稅。All prices above are with 5% tax included.
本報價單價錢如有變動依賣場實際價格為準。Prices and products are subject to change. For current product availability and price confirmation please Contact Warehouse.
** 售價以匯款日當天價格為準。 ** Sell prices are based on warehouse price on the date of remittance.
貨物數量經買賣雙方清點簽收後，Costco 概不負責。All purchase quantities should be counted at time of delivery. Costco will not be responsible for any discrepancies once the purchase has been received.
本公司對於您所購買之商品皆提供商品滿意保證，若您有任何不滿意，30天內* 請將完整包裝之商品 (含商品保證書)攜回至賣場退貨櫃檯，進行退貨手續。 (退貨時，請攜帶收據、發票與公司發票章；若您是以信用卡付款，同時亦請付款人持信用卡一同前往。) *30天內，意指從您收到貨品起算30天。
Costco provides members 100% Satisfaction Guarantee： We guarantee your satisfaction on every product we sell with a full refund. To return a product purchased through the Costco Business Delivery, please bring the product in its original packaging (including its warranty letter) to the in-store Return Exchange Counter within 30 days. (Please remember to bring your receipt, " invoice and tax no. chop. If the purchase was made with a credit card, the credit card holder should bring the card with " him/her when refunding.) *Within 30 days will be counted from the date you receive the merchandise you ordered.

Costco 承辦人簽章
ostco Representative Signature