POWER HOUSE .DOC. REF.

NO PH–IMS-SP11-FR03

Order Review for REVISION / 00/01

ISSUE
Product or DATE 07-07-2015
Service PAGE 1 OF 1

Order Review No. :

Order asked by :  Oral  Fax attached  Written order

Delivery required on :

Product or Service: Quantity : Dilevery date

Customer Requirements or Modifications :

This Order is Approved with the following

1) Specifications
(modifications)

2) Quantity
3) Delivery date

This Order is Not Approved for the following Reason

Sales Rep Sales & Markting Director Date :