First Responder Personal Purchase Program

First Responder Personal Purchase Program
Burris enthusiastically supports individual law
enforcement officers and other qualified first
responders with this special discount program.
Burris, through its Law Enforcement Distributors,
offers special discount pricing to assist in
accessorizing individual firearms. All items
purchased through this program are not eligible
for any other discounts or rebates.
Qualified purchasers for this program include:
• Sworn Law Enforcement Officers, including City,
Township, County, and State
• Federal Law Enforcement Officers
• Corrections Officers, including Parole and Probation Officers
• Retired Law Enforcement Officers with retired credentials
• State licensed Security Company Officers
• State licensed Para-Medics and EMT’s
• Fire Fighters, including volunteers
• Court Judges
• District Attorneys and Deputy District Attorneys
• Active and Retired U.S. Military personnel - all branches
Shipping Address:
Billing Address:
Name_____________________________________________
Name______________________________________________
Address___________________________________________
Address____________________________________________
City_______________________________________________
City________________________________________________
State_______________________________Zip____________
State_______________________________Zip_____________
Personal Phone:____________________________________
Email Address:______________________________________
QTY
PRODUCT#
First Responder
Price
DESCRIPTION
*Freight covers Ground shipping to
the 48 continental states. Call for
freight quotes to Alaska & Hawaii.
Freight
$17.00
Subtotal
Tax (If Applicable)
TOTAL $
Submitted By__________________________________________ Date ________________________Total__________________
Payment: q Check
(Signature) Order not valid if not signed
Credit Card q MasterCard q Visa q Discover American Express not accepted
CC#_________________________________ Exp ________
Name on Card ____________________________________
CVV#_________ (3 Digit Security # on Back of Card)
ATTACH A LEGIBLE COPY VERIFICATION FORM AND ID OR
LETTERHEAD. EMAIL, FAX OR MAIL ALL FORMS TO ONE OF
THE BURRIS LISTED LAW ENFORCEMENT DISTRIBUTORS
SHOWN AT THE TOP OF PAGE 3.
1
CREDENTIAL VERIFICATION FORM
First Responder Verification Form
Qualified purchasers for this program include:
• Sworn Law Enforcement Officers, including City,
Township, County, and State
• Corrections Officers, including Parole and Probation Officers
• Retired Law Enforcement Officers with retired credentials
• State licensed Security Company Officers
• State licensed Para-Medics and EMT’s
• Fire Fighters, including volunteers
• Court Judges
• District Attorneys and Deputy District Attorneys
Without proper employment identification, authorization or
credentials you will not receive the discounted pricing.
I, ___________________________________________________
(Print Name of Authorized Purchaser)
certify that I am a (n) __________________________________ employed by _______________________________
(Rank/Position)
(Employer)
Or
Military/Federal Officer Verification Form
Qualified purchasers for this program include:
• All Federal Law Enforcement Officers
• Active U.S. Military personnel - all branches
• Retired U.S. Military personnel - all branches
Without proper employment identification, authorization or
credentials you will not receive the discounted pricing.
I, ___________________________________________________
(Print Name of Authorized Purchaser)
certify that I am a (n) __________________________________ employed by _______________________________
Duty Station:_____________________________________________________________________________________
Military Unit/ Agency Address:_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
2
First Responder Program Price
1/1/2016 through
through 12/31/2016
ValidValid
7/1/2015
12/31/2015
Please submit a completed order form (page 1) with your payment, a legible
copy of your Driver’s License, and the front and back of your Federal or State
Police Commission ID (if applicable), and a signed Credential Verification
Form (page 2) to the Burris Law Enforcement Distributor listed below.
**Order will not be processed if all forms are not signed and completely filled out.
Proforce Brea,CA Location:
655 Berry St. Suite H
Brea, CA 92821
(714) 257-9075
Mark.Salazar@proforceonline.com
Item
Model
Reticle
First Responder
MSRP
Price
ELIMINATOR® LASER SCOPE®
200116
4X-16X-50mm Eliminator III
Proforce Prescott, AZ Location:
3009 AZ-89
Prescott, AZ 86301
800-367-5855
Item
Model
Reticle
First Responder
MSRP
Price
AR-TRIPLER
X96 Eliminator + Wind
$1,799
$1,133
XTREME TACTICAL™ XTR II SCOPES -- 30mm & 34mm
300216
AR-Tripler Gen2 with Pivot Ring Xhigh 1" Height
$299
$188
AR-TACTICAL MOUNTS
201001
1X-5X-24mm illum
Ballistic CQ Mil RFP
$959
$604
410345
AR-PEPR Scope Mount 34mm w/Picatinny Tops, 20 MOA
$152
$96
201002
1X-5X-24mm ill, FFire 3, PEPR, TMnt
Ballistic 5.56 Gen3 RFP
$1,319
$831
410341
AR-PEPR Scope Mount 30mm w/Picatinny Tops
$107
$67
201011
1.5X-8X-28mm ill, FFire 3, PEPR, TMnt Ballistic 5.56 Gen3 DFP
$1,439
$907
410342
AR-PEPR QD Scope Mount 30mm w/Picatinny Tops
$139
$88
201020
2X-10X-42mm
G2B Mil-Dot Front Focal
$959
$604
410343
AR-PEPR Scope Mount 1" with/Picatinny Tops
$107
$67
201030
3X-15X-50mm illum
G2B Mil-Dot Front Focal
$1,199
$755
410344
AR-PEPR QD Scope Mount 1" with/Picatinny Tops
$139
$88
201040
4X-20X-50mm Illum
G2B Mil-Dot Front Focal
$1,319
$831
420188
AR-TER Ext Ring xhigh 1" High 30mm One Ring QD
$64
$40
201050
5X-25X-50mm Illum
G2B Mil-Dot Front Focal
$1,439
$907
SPEEDBEAD™ SYSTEMS (SpeedBead Mount + 8 MOA FastFire 3 Sight)
MTAC® -- 30mm
300241
SpeedBead, 12 Ga. Benelli M2, Montefeltro, Ultra Light
$299
$188
200437
1X-4X-24mm illum
Ballistic CQ
$479
$302
300245
SpeedBead, Remington 870
$299
$188
200429
1.5X-6X-42mm illum
Ballistic CQ
$479
$302
300248
SpeedBead, Remington 1100, 1187
$299
$188
200463
4.5X-14X-42mm PA
G2B Mil-Dot
$659
$415
FASTFIRE™ SIGHTS and MOUNTS
®
FULLFIELD TAC30 -- 30mm
200433-FF 1X-4X-24mm ill, FFire 3, PEPR
Ballistic CQ
$599
$377
AR-PRISM SIGHTS
300232
FastFire 3 w/picatinny mount 4 MOA Dot
$251
$158
300234
FastFire 3 w/picatinny mount 3 MOA Dot
$299
$188
300236
FastFire 3 w/picatinny mount 8 MOA Dot
$299
$188
410339
Scope Tube FastFire Mount 34mm
$80
$50
300208
AR-332 3X - 32mm
Ballistic CQ
$419
$264
410324
Mount - Beretta 92/96 /90-TWO/Cougar/ Taurus PT99
$59
$37
300210
AR-536 5X - 36mm
Ballistic CQ
$479
$302
410326
Mount - Glock all
$59
$37
410327
Mount - Sig Sauer P226
$59
$37
410336
Mount - Smith & Wesson M&P
$59
$37
AR-F3 TACTICAL SIGHT
300215
AR-F3 Flatop FastFire Sight
Red Dot 3 MOA
$359
$226
Ask your LE Distributor about the full line of Burris
products and agency pricing.
3