Purchase Order 15

Supplier Details:

Company TEST SUPPLER

Contact
Address HOLTSVILLE, NEW YORK 00544 Suffolk

Submit your response to:

Company TEST Vision America

Contact PRC17 Student
Address XX102 Main Street
HOUSTON, TX XX003 Harris
Phone 1-650-555-5555

T
Fax
E-mail prc17.student_zpbs@oracledemos.com

This document has important legal consequences. The information contained in this document is proprietary of TEST Vision
AF
America. It shall not be used, reproduced, or disclosed to others without the express and written consent of TEST Vision America.

This agreement between TEST Vision America and TEST SUPPLER is authorized for binding commitment. The parties hereto have
read and executed this agreement as of the ______day of __________, _______.
DR

1
Purchase Order 15
Order 15
Order Date 19-AUG-2020
Change Order 0
Change Order Date 19-AUG-2020

Revision 0
Ordered 1,000.00 USD

Sold To TEST Vision America Supplier TEST SUPPLER

XX102 Main Street HOLTSVILLE, NEW YORK 00544 Suffolk
HOUSTON, TX XX003 Harris

Bill To TEST BU Ship To TEST LOC Addr

TEST LOC Addr CALIFON, NJ 07830 Morris

T
CALIFON, NJ 07830 Morris UNITED STATES
UNITED STATES

Notes USD = US Dollar AF

Customer Account Number Supplier Number Payment Terms Freight Terms FOB Shipping Method
1388 Immediate
Confirm To Deliver To Contact
PRC17 Student PRC17 Student
Phone 1-650-555-5555 E-mailprc17.student_zpbs@oracledemos.com
DR

Line Item Price Quantity UOM Ordered Taxable

1 TEST NEW 1,000.00 Ea
TEST1002

Promised 1 Ea 1,000.00

Requested
8/22/20

Requested and Promised Dates correspond to the date of arrival at the Ship-to Location.

Line Total 1,000.00

Total 1,000.00

Proprietary and Confidential 2