Order Form, Washington Procurement Supply


Order #		Date
Company Name		Ship to	If same as Company, leave these words.
Bill To	If same as Company, leave these words.	Mark	If same as Company, leave these words.
FOB		Delivery Date

Terms:
ITEM	DESCRIPTION	QTY	U/I	UNIT PRICE	TOTAL
0001
0002
0003
				TOTAL
Taxable Authorized by
Account# Telephone
EMAIL FAX
NOTE If you are not a regular customer, we will contact you to setup an account. Upon receipt of this order, we will acknowledge acceptance or contact you to renegotiate terms. Add me to your mailing list.
Please double check all entries before sending!!				Thanks for the order!