| To | Ship To |
|---|---|
|
, Attn: Tel: Fax: |
, Tel: Fax: |
| Order # | Order Date | Required by | Salesperson | Shipping Point | Ship Via |
|---|---|---|---|---|---|
| Item | Number | Description | Qt'y | Price | Disc % | Amount | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| . | |||||||||||||||
| Total | Subtotal | ||||||||||||||
| on @ % | |||||||||||||||
|
***** /100
Terms Net days |
Total | ||||||||||||||
| Notes | All prices in Funds |
| Special order items are subject to a 10% order cancellation fee. |
X |