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PURCHASE ORDER

<Company Name>
<Street Address>
<City>, <State> <Zip>

PO Number:
PO Date:
Vendor ID:

Purchase From:
<Vendor Name>
<Vendor Street Address>
<City>, <State> <Zip>

Ship To:
<Company Name>
<Company Street Address>
<City>, <State> <Zip>

Contact Name:
<Name>
Shipping Method
<UPS>
Item Description

<12345>
<7/15/2009>
<Vendor ID>

Contact Name:
<Name>
Required By Date
<Date>
Unit Price
Amount

Payment Terms
<Net 30 Days>
Quantity

<Item 1>
<Item 2>
<Item 3>
<Item 4>
<Item 5>
<Item 6>
<Item 7>
<Item 8>
<Item 9>
<Item 10>

Approved By:
X _____________________________________________________

1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00

$
$
$
$
$
$
$
$
$
$

5.00
5.00
5.00
5.00
5.00
5.00
5.00
5.00
5.00
5.00

$
$
$
$
$
$
$
$
$
$

5.00
5.00
5.00
5.00
5.00
5.00
5.00
5.00
5.00
5.00

Subtotal $
Freight
Sales Tax
Order Total $

50.00
5.00
3.00
58.00

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