| To: | Ship To: |
|---|---|
|
, Attn: Tel: Fax: |
, Attn: Tel: Fax: |
| Order # | Order Date | Required by | Contact | Shipping Point | Ship Via |
|---|---|---|---|---|---|
| Item | Number | Description | Qt'y | Price | % | Amount | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| . | |||||||||||||||
| Total | Subtotal | ||||||||||||||
| on @ % | |||||||||||||||
| Total | |||||||||||||||
| Terms Net days | Total | ||||||||||||||
| Tax included | |||||||||||||||
| All prices in Funds | |||||||||||||||
| Notes |
|
X |