Reach Dane PURCHASE ORDER INFORMATION 2096 RED ARROW TRAIL Issued By FITCHBURG, WI Date Issued PHONE: (608) 275-6740 Purchase Order TAX EXEMPT #: ES10156, TAX ID #: 39-1418945 # NOT VALID WITHOUT APPROVED NUMBER * SECTION MUST BE COMPLETED/SIGNED REQUEST TO PURCHASE * Phone # Vendor / Supplier Page of * * Select Method of Purchase: Street Address PO Purchase Order Credit Card * City/State/Zip (authorized purchasers only) Store Purchasing Card GL UNIT TOTAL REQUESTED DEPT LOC ITEM DESCRIPTION CATALOG # QTY RECVD ACCT # COST COST BY Shipping and handling charges (if applicable) Total Cost: * Date Order Placement Information Staff Requesting Date Ordered: * Date Ordered By: Department Approval Confirmation #: * Date Expected Delivery Executive/Finance Director Approval (if required) Date: *PRICE COMPARISONS ARE REQUIRED. REQUESTS WILL NOT BE PROCESSED WITHOUT PRICE QUOTES. *PLEASE CHECK ONE AND ATTACH PRICE QUOTES. PRICE QUALITY SERVICE SOLE VENDOR DISCOUNT MINORITY/WOMEN OWNED OTHER NOTES: PLEASE GIVE TO ADMIN TO SPECIAL DELIVERY INSTRUCTIONS: ORDER
Reach Dane PURCHASE ORDER INFORMATION 2096 RED ARROW TRAIL Issued By FITCHBURG, WI Date Issued PHONE: (608) 275-6740 TAX EXEMPT #: ES10156, TAX ID #: 39-1418945 Purchase Order # NOT VALID WITHOUT APPROVED NUMBER * SECTION MUST BE COMPLETED/SIGNED REQUEST TO PURCHASE * Vendor / Supplier Phone # Page of * Street Address * Select Method of Purchase: Purchase Order PO Credit Card (authorized purchasers only) * City/State/Zip Store Purchasing Card DEPT LOC GL ACCT # ITEM DESCRIPTION CATALOG # UNIT COST QTY TOTAL COST RECVD REQUESTED BY Shipping and handling charges (if applicable) Total Cost: * Staff Requesting Date Order Placement Information Date Ordered: * Department Approval Date Ordered By: Confirmation #: * Executive/Finance Director Approval (if required) Date Expected Delivery Date: *PRICE COMPARISONS ARE REQUIRED. REQUESTS WILL NOT BE PROCESSED WITHOUT PRICE QUOTES. *PLEASE CHECK ONE AND ATTACH PRICE QUOTES. PRICE QUALITY SERVICE SOLE VENDOR DISCOUNT MINORITY/WOMEN OWNED OTHER NOTES: SPECIAL DELIVERY INSTRUCTIONS: PLEASE GIVE TO ADMIN TO ORDER