Purchase Order Template
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1
2
3PURCHASE ORDER
Date ____________
Purchase Order No. ____________
Account/Customer ID No. ____________
To:
Luz C Levine
3723 Stadium Drive
Worcester, MA 01610
Tel.: (508) 296-0738
Shipping Method
Shipping Terms
Payment Terms
FedEx
FOB destination
Due upon receipt
Item No.
Description
Quantity
Unit Price
Total
Subtotal
__________
Sales Tax
@ __________
__________
Shipping
__________
Other
__________
Discount
(__________)
@ __________
Total Amount Payable
__________
Special Instructions:
1. Please contact us immediately if you are unable to fulfill the order as requested.
2. Please enclose two copies of the invoice with the order.
Authorized by
Date
Purchase Order (Rev. 133C783)
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