FORUM US, INC.

1196 Petroleum Pkwy

Broussard, LA 70518

Phone 337.837.1676 Pro Forma Invoice

Fax 337.837.6599
Tax ID # 26-3748750

Order No.: S19166

Order Date: 03/23/16
B EIGHT EQUITY CORP S West Atlantic Cargo / Eight Equity Customer PO: 105
I CALLE 50 CON AV. ELVIRA MENDEZ H 11139 NW 122ND St # 6 Bill-to Customer No.: PC0009516
L FINANCIAL CENTER TOWER PISO16 CIUDAD DE I Medley, FL 33178-3171 Shipment No.:
L CIUDAD DE PANAMA, ZONA 5, 0816-02900
PANAMA P United States External Doc No.:
PA Quote No.:
T Panama T Location Code: 100
O O Fufillment:

Attention Shipping Terms Shipping Agend Code Payment Terms

Ex WORKS UPS CASH IN ADVANCE
Final Destination Sales Person Inside Sales Person Invoice Currency
PAN KELLY USD

Line # Cust. PO Line # No. Description Total Wt. Quantity U/M Unit Price Disc % Net Price Amount Ship Date
10000 517-152 SENDING UNIT, with 1502 union 2 EACH 331.20 662.40 662.40 03/31/16
20000 109547-110XP HOSE ASSY, 10 ft, 15K WP 2 EACH 260.36 520.72 520.72 03/31/16
30000 98-900A-220 DISCONNECT, Set, screw type High Pressure 2 EACH 100.80 201.60 201.60 03/31/16
40000 DISCONNECT, Set, screw type
50000 High Pressure
60000 21-80 DIAPHRAGM, Rubber, Sending unit, (E40) 6 EACH 9.00 54.00 54.00 03/31/16
70000 ABO-450SS1K-LF GAUGE, PRESSURE, 4-1/2" PH/SS 0-1,000 1/2" 2 EACH 178.80 357.60 357.60 03/31/16
NPT, LM, LF
80000 ABO-450SS2K-LF GAUGE, PRESSURE, 4-1/2" PH/SS 0-2,000 1/2" 2 EACH 178.80 357.60 357.60 03/31/16
NPT, LM, LF
90000 ABO-450SS5K-LF GAUGE, PRESSURE, 4-1/2" PH/SS 0-5,000 1/2" 2 EACH 178.80 357.60 357.60 03/31/16
NPT, LM, LF
100000 101349-101 HAND PUMP, with swivel, aluminum 1 EACH 84.86 84.86 84.86 03/31/16
110000 HAND PUMP, with swivel,
120000 aluminum
130000 A11 FLUID, Weight Indicator, Red, quart 3 EACH 10.20 30.60 30.60 03/31/16
140000 FLUID, Weight Indicator, Red, quart

WIRE / ACH TRANSFER to:

Wells Fargo Bank, N.A.
Account #:4123812778
ABA/Routing#: 121000248
SWIFT#: WFBIUS6S

ISO 9001:2008
Forum Terms and Conditions Apply Page 1 of 2
 FORUM US, INC. 1196 Petroleum Pkwy
Broussard, LA 70518

Phone 337.837.1676 Pro Forma Invoice

Fax 337.837.6599
Tax ID # 26-3748750

Order No.: S19166

Order Date: 03/23/16
B EIGHT EQUITY CORP S West Atlantic Cargo / Eight Equity Customer PO: 105
I CALLE 50 CON AV. ELVIRA MENDEZ H 11139 NW 122ND St # 6 Bill-to Customer No.: PC0009516
L FINANCIAL CENTER TOWER PISO16 CIUDAD DE I Medley, FL 33178-3171 Shipment No.:
L CIUDAD DE PANAMA, ZONA 5, 0816-02900
PANAMA P United States External Doc No.:
PA Quote No.:
T Panama T Location Code: 100
O O Fufillment:

Attention Shipping Terms Shipping Agend Code Payment Terms

Ex WORKS UPS CASH IN ADVANCE
Final Destination Sales Person Inside Sales Person Invoice Currency
PAN KELLY USD

Line # Cust. PO Line # No. Description Total Wt. Quantity U/M Unit Price Disc % Net Price Amount Ship Date
150000 FREIGHT Freight Charges 1 EACH 64.69 64.69 64.69 03/31/16
Total Weight Subtotal: 2,691.67
Discount: (0.00)
Tax: 0.00
Total USD: 2,691.67

WIRE / ACH TRANSFER to:

Wells Fargo Bank, N.A.
Account #:4123812778
ABA/Routing#: 121000248
SWIFT#: WFBIUS6S

ISO 9001:2008
Forum Terms and Conditions Apply Page 2 of 2