LOS ANGELES COMMUNITY COLLEGE DISTRICT
DEPARTMENT OF FACILITIES PLANNING AND DEVELOPMENT
SUSTAINABLE BUILDING PROGRAM

Packing Slip Substitute

Packing Slip Substitute Details
Vendor Information: PO # Related Invoice#

Sales Person Phone #

Order Date:

Company Name
Received Date:

Street

Shipped Via: Common Carrier

City, State, Zip Code

Ship To Location: Bill To:

College Company / Vendor

Street Street

City, State, Zip Code City, State, Zip Code

Qty Qty Qty

Line # UOM Item # Description / Product
Ordered Shipped Backordered
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19

Form ACCT-0010 Page 1 of 12 Rev 08.21.2015

 20
21
22
23
24
25

Notes:

Authorized Receiving Person Signature:

When attaching a PO as a listing of item

fill out the top portion of this document
statement in the Notes box "All items rec
Name: Received Date: Purchase Order".

Form ACCT-0010 Page 2 of 12 Rev 08.21.2015

 Related Invoice#

Description / Product

Form ACCT-0010 Page 3 of 12 Rev 08.21.2015

 When attaching a PO as a listing of items received, please
fill out the top portion of this document, add a reconciling
statement in the Notes box "All items received per attached
Purchase Order".

Form ACCT-0010 Page 4 of 12 Rev 08.21.2015

  
LOS ANGELES COMMUNITY COLLEGE DISTRICT
DEPARTMENT OF FACILITIES PLANNING AND DEVELOPMENT
SUSTAINABLE BUILDING PROGRAM
Packing Slip Substitute
Packing Slip Substitute Details
Vendor Information: PO # Related Invoice#

Sales Person Phone #

Order Date: Shipped Date:

Company Name
Due Date: Received Date:

Street

Shipped Via: Acct / Order / Sales#:

City, State, Zip Code

Ship To Location: Bill To:

College Company / Vendor

Street Street

City, State, Zip Code City, State, Zip Code

Qty Qty Qty

Line # UOM Item # Description / Product
Ordered Shipped Backordered
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19

Form ACCT-0010 Page 5 of 12 Rev 08.21.2015

 Qty Qty Qty
Line # UOM Item # Description / Product
Ordered Shipped Backordered
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35

Form ACCT-0010 Page 6 of 12 Rev 08.21.2015

 Qty Qty Qty
Line # UOM Item # Description / Product
Ordered Shipped Backordered
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80

Form ACCT-0010 Page 7 of 12 Rev 08.21.2015

 Qty Qty Qty
Line # UOM Item # Description / Product
Ordered Shipped Backordered
81
82
83
84
85

Notes:

Authorized Receiving Person Signature:

When attaching a PO as a listing of item

fill out the top portion of this document
statement in the Notes box, and sign.
Name: Date:

Form ACCT-0010 Page 8 of 12 Rev 08.21.2015

  
ES COMMUNITY COLLEGE DISTRICT
T OF FACILITIES PLANNING AND DEVELOPMENT
SUSTAINABLE BUILDING PROGRAM

Related Invoice#

Shipped Date:

Received Date:

Acct / Order / Sales#:

Description / Product

Form ACCT-0010 Page 9 of 12 Rev 08.21.2015

 Description / Product

Form ACCT-0010 Page 10 of 12 Rev 08.21.2015

 Description / Product

Form ACCT-0010 Page 11 of 12 Rev 08.21.2015

 Description / Product

When attaching a PO as a listing of items received, please

fill out the top portion of this document, add a reconciling
statement in the Notes box, and sign.

Form ACCT-0010 Page 12 of 12 Rev 08.21.2015