rusty rusty.. walker @ afbic @ afbic. com. com |
ken. jennings ken. jennings @ afbic @. afbic com. com |
479-719-9255 |
479-409-4844 |
|
East
East Benton County County AGENTS AGENTS::
|
West
West Benton Benton County County AGENTS AGENTS::
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|
nsurance Company
Dorothy Clark Clark
Robin
Robin Wright Wright
Michael Morse Morse
Southern Farm
Wes Hunt
Wes
Bureau
Hunt
Casualt orm nsurance( Arkansas
Company
Sam
Sam Rogers
) Rogers
Child-Saver
Nathan
Nathan Bemis Program Bemis Orde
ST complete all lines to
Matt process
Matt Guthrie Guthrie
Southern Farm order
Straton
Straton
Bureau
Andres Andres
Casualt rder
Form nsurance Company
Kyle
Kyle Woodruff
Please print clearly
Rita McCann, CSR gramOrder Required
Rich Howard
Form to Child-Saver & legibly
Rita McCann this is, CSR your shipping
Program label. You
ST complete all lines to process orm( Arkansas
Rich
)
Howard process order
Infant Southern Farm Bureau Casual order
Member Name
/ Child Car Seat Membe
Pr Ryleigh Montogomery
Please print clearly & legibly this is your shipping label. You
County
ST complete all lines to process
Required order to
Child-Saver Program and Orde State
ST black complete ink all
PEA lines
PEA RIDGE RIDGE to process OFFICE OFFICE order
Will process UPS 479-488-6226 deliver order
Member to a:
Please Name print clearly legibly this is your shipping label
Membe Yo
.
Required
Please to au Casualty Insurance process Company
Required
County complete
Please print all clearly lines and & legibly type this name is your and shipping address to and label State or. pr Yo order business black ink process
Will UPS deliver order residence
Member to a:
Name
Daytime
Membe r question Program about order Order)
Form
Member Name
Membe
Name
Southern
County Farm Bureau Casualty
Southern Insurance and State black ink black ink
Will
Please
UPS check deliver business one
County
Phone Farm and
# Comp B
Please complete all lines and type name and address State or pri r shipping label. You MUST complete all lines to process orderto
Child-Saver Program Order Form
A Farm
Will UPS deliver Bureau residence to a: dress)
Membership can can save save you
Daytime
( Arkansas
Child-S
( In) c you ed question to
Member about order No.)
Required to business
Address order and State question about order
MORE THAN $ $ 2,500 business process Name
Please
Please complete all lines and type name and address or pr
Please check one order print complete clearly & legibly all this lines is your shipping and type label. You name
MUST
Please and complete print
Phone clearly address all lines &# legibly to or proce th pr residence
Daytime f dress question) about
( Zip order
)
Member Name
( No po boxes accepted
Member
Member No –.
Must Name deliver and address to a: or print in) black ink
Daytime use physic
( In c
Please check
County
Will UPS deliver one
Name to a: and State
County
Daytime
Please check
Address
Phone one
Name
Phone # business ddress
Phone residence
# business ddress item) will
Zip
be
) gender neutral
In
( In case of question about order) eck one
BC110 $$ Please
( City residence complete) all lines
( and No type po name boxes and address accepted or print
Please in – complete black Must
( State ink all use lines) physic and type
( In
Please check
Address one
SAVE
SAVE
Daytime
Address
UP UP TO TO
Must use physical item will
Zip address)
Name
( Zip be)
Cosco gender Finale neutral 2-in-1
500 No po
Bonus
Bonus Cash Cash
20 boxes % Phone accepted #
Name
Must use physic
( City)
No
( No choice po boxes of accepted fabric pattern – Must use or physic colo
( In case of question at at participating
( State about order))
( State)
( Zip) item item will will be gender
Booster
Eligible be Vehicles
Valid gender
Valid
22-491FSM on: F-150 on new new neutral Seat
Address
Address
CC123FSM al attern or color
Eligible
$ 25.00 / co-pay Rangers Lightning neutral
Rangers per, F-150s-550s, Super, seat
F-150s-550s Duty,.
F-150.
Cosco – Vehicles item will: F-150
Pronto be gender Lightning,
Ranger
Excluding
Excluding
, Maverick the Raptor the Raptor
OFF OFF
Choice
Choice Hotels Hotels
BC110
High neutral, Super
City State Back
( City
Duty,)
F-150
( No po, boxes accepted – Must use physical address)
( No po boxes acce
No choice
Cosco of fabric Scenera pattern Next
( State or) colo
Ranger, Maverick
M
BC110
22-491FSM
Forward-facing
Cosco
Booster
Finale with Seat
( City)
( State)
( City)
( Zip) ra
-1 Next
Cosco Pronto 2-in-1 harness High Back
No choice
Convertible of
CC123FSM fabric Car pattern Seat or col ar Seat
Cosco Finale
Booster
$ 2-in-1
30-65
$ 15.00 pounds / co-pay
Booster and Seat belt-positioning per seat
Seat
No choice
No of fabric choice pattern
$ of fabric pattern or col seat per seat
Booster
$ 15.00 Seat / co-pay per seat
Cosco 25.00 or / co-pay booster 25.00 co-pay 40-100 per pounds seat
Join Online CC123FSM
Scenera color – per item Next
No seat will choice be gender of fa
Join Online Today Today CC123FSM arness use
Forward
$ 25.00 Facing / co-pay
Forward only Facing per 40 only seat – 100 40 – 100 lbs lbs.
CC123FSM
.
Lightweight
Child
and
Booster
easy to move
Cosco Scenera
Seats
BC1
CC
Convertible
2 modes of Car use Seat
Cosco Scenera Next
Next
Cosco
Cosco Fin ositioning
40 lbs.
Forward-facing
Removable
Child
Removable, Booster Fabric, Fabric with harness Pad
Pad
Convertible Car
$
Cosco Scenera Next
22-40 nds lbs.
Must
Forward-facing
Dishwasher-safe
Must use
30-65 use pounds vehicle and
Seats lap with vehicle cup harness lap holder and shoulder
Rear 25.00 Seat
Convertible facing / co-pay 5 – Car per Seat seat
Booste
Conver lbs. o ights move belt-positioning and shoulder
$
FOR 25.00 / co-pay per ONLYConvertible seat Car 40 Seat!! $ 25.00
$ 25.00 / co-p / c holder tions
30-65
Easy-to-clean pounds
Back and belt-positioning booster 40-100
machine belt removes for pounds
washable
Forward 25.00 Facing co-pay 22-40 per seat lbs. backless booster
2 modes of use otection ashable booster 40-100 pounds arfb
$ arfb. com
25.00
2. modes
/ com join
/ co-pay / joinof use per seat
Forward-facing
2 m
Back
Lightweight removes and dryable
40 and for backless easy fabrics
– 100 lbs. cs with up
Adjustable height to move
positions booster
Rear facing 5 – 40
Rear lbs
5. harness heights facing modes 5 of – 40 use lbs
30-65. pounds
Rear and fa
Exceeds
Lightweight and easy to move
For a full list of member benefits, visit arfb. com / member-benefits ter tandards
Dishwasher-safe Federal
40 $
– 100
Slide Safety lbs cup out. cup Standards holder p Holder
Dishwasher-safe cup holder
Easy-to-clean
Adjustable 25 $ Forward
For a full Facing list of member 22-40 benefits
Forward
3 lbs buckle
2., visit arfb. com / member-benefits modes locations of use booster
Forward 40-1 F
5 harness heights
Rear facing Facing 22-40 lbs lbs
Lightweight.
5 and har machine height 25 positions washable 3 buckle locations
Rear facing 5 – 40 lbs.
Easy-to-clean machine washable
Forward
Side
5 harness Impact Facing
Protection heights
Dishwasher-sa
3 buc 22-40 lbs eat Limit
Slide and
SCAN TO VIEW
Child
dryable out cup
Safety
fabrics holder
Side Impact Protection
SCAN and
Child dryable
Safety
5
Forward point Facing TO VIEW 22-40 lbs. fabrics
3 buckle harness harness locations heights with up
Easy-to-clean
Side ma Im
5 point harness with up and
5 point dryab h it Exceeds Federal Safety Standards tal
Description
Exceeds Federal
Seats
Seats Safety Standards
Total
ALL
ALL THE
5 harness front buckle BENEFITS adjuster heights front adjuster
Side
THE
Impact
BENEFITS
Protection locations
Exceeds Federal froS
Removable Cup
Removable Holder
3 buckle locations
5 enera Next Convertible Seat
Side point Impact harness Cup Protection with Holder
Remova up itBentonville | 479-273-7786 | 479-273-7786 $
25.00Total
Side Impact Protection
Pea
Pea Ridge Ridge | 479-488-6226 | 479-488-6226 point front harness adjuster with up onto High
3 Seat Back Siloam
Siloam Booster
Springs Springs Seat | 479-524-8400
| 479-524-8400
$ 15.00
5 point harness Limit ARFB
ARFB. with
COM. up COM ble Seat it Removable front adjuster
2025 BENTON
$ COUNTY 25.00 FAIR
Total
2 front
3 Cup adjuster 121
Seat Holder Qty
Model
Description
Qty Years
Model
• 1904-2025
L Order Total
Removable Cup Holder
Total
Removable Cup Holder ble eat your Seat check payable
$ to 25.00
Qty
CC123FSM
Model
Cosco Scenera Next Convertible Seat
CC123FSM
Descripti
$ 25.00
Co
: CHILD SOURCE
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