SALES ORDER FORM

Customer No:
Invoice No:
P.O. No. 
Customer:
Ship To:
Phone No:


Fax No:


Email Address:


Order Date:
Contact:
Needed By:
Ordered By:
Ship Via:
Category:
  Item No. Quantity Price Weight Remarks
1.




2.




3.




4.




5.




6.




7.




8.




9.




 

Freight Paid By:

Cust.


Adex


F.O.B.


UPS Zone:
Total Weight:
Freight Amount:
Freight Total:
Notes:



Sales Order No:

NO MINIMUM ORDER REQUIRED
VISA & MASTERCARD ACCEPTED

TAXES: All applicable taxes are required by law.

For more information about any of our products,
please contact our Customer Service Department

In the U.S.A. phone:
(800) 873-4776
Outside the U.S.A. phone: (951) 653-9122
Fax: (951) 653-9133
E-mail at sales@adexmed.com

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