PURCHASE ORDER

[COMPANY NAME]
[Street Address] P.O. NO. [100]
[City, ST ZIP Code] DATE October 12, 2017
[Phone] [Fax] CUSTOMER ID [ABC12345]
[e-mail]

[Name] [Name]
[Company Name] [Company Name]
VENDOR [Street Address] SHIP TO [Street Address]
[City, ST ZIP Code] [City, ST ZIP Code]
[Phone] [Phone]

SHIPPING METHOD SHIPPING TERMS DELIVERY DATE

QTY ITEM # DESCRIPTION JOB UNIT PRICE LINE TOTAL

50.00 A-098 demo keys Smith $ 12.00 $ 600.00

SUBTOTAL $ 600.00
SALES TAX 5%
1. Please send two copies of your invoice.
2. Enter this order in accordance with the prices, terms, delivery method, and
specifications listed above.
TOTAL $ 630.00
3. Please notifiy us immediately if you are unable to ship as specified.
4. Send all correspondence to:
[Name]
[Street Address]
[City, ST ZIP Code]
Authorized by Date
[Phone]
[Fax]