Electrolux EFC 009 X Manuale Utente Pagina 33

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Vendor: Supermarket Parts Warehouse
Attn: ________________________________
Address:POBox368/510WildTurnpike
Mountaindale,NY12763
Contact
Person: ________________________________
Phone: (800)767-9855
Fax: (845)436-7677
Shipto:
Company:_______________________________
Street Address: __________________________
City/State/Zip:___________________________
Attention:_______________________________
Contact #:_______________________________
Shipping Method:________________________
Special requirements / instructions:
TOTAL AMOUNT
(Shipping/Handling Prepay & Add)
$
Charge To:(Visa,AmericanExpress,Mastercard,Discover)__________________________Exp. Date___/___
Bill My Account(AcctNameOr#)_________________________
Print Name_________________________Contact #______________ Date___________
Purchase Order #_____________________
SMPW Sales Order Form
Item No. Description Qty. Unit Unit Price Total
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