Laserfiche WebLink
Purchase Order Form <br />Account Manager <br />Cell Phone <br />Check box if Billing same as Shipping El <br />Billing Account Num 1323573 <br />_............._...._..._. _._..... ..... ...... ...... .......... ..... ........................ ....... _ ....... _....... _................ <br />Company Name <br />Contact or Department <br />Street Address <br />Addt'I Address Line <br />_.._.__._..._.. ._.............._.._.___._—_..._..._..__._... ...... .......................... ......................... <br />City, STZIP <br />Phone <br />Authorized Customer Initials <br />Purchase Order Date <br />Expected Delivery Date <br />Stryker Quote Number <br />stryker <br />230321082506 <br />Shipping Account Num <br />...... ............. ..................... _... <br />1323573 <br />- _ <br />Company Name <br />_._.._..__..-....................................__._......__.._.._.__._._._.._._._..__._.._.__..__._................... <br />_._._..._..............._..__._.._.._...._..__..._._...._.._...._........ _............. <br />INDIAN RIVER COUNTY <br />Contact or Department <br />Steve Greer <br />Street Address <br />..._..._.._ ............._._._.._................_.._ <br />4225 43RD AVE <br />Addt'I Address Line <br />.._._ ... _......................................... <br />... ............. ..... ...._....._........................................ ._. <br />__ <br />City, ST ZIP _ <br />__............._.._.._..._.__..._._._.__ <br />...--.-_.__.._._........................................... _... ._...._. <br />ER ._._.... <br />VO BEACH._.._, FL 32967 <br />_. .__.��._.._........................ <br />Phone <br />(772)226-3864 <br />Authorized Customer Initials <br />DESCRIPTION QTY TOTAL <br />REFERENCE QUOTE <br />Accounts Payable Contact Information <br />Name <br />Email <br />Phone Stryker Terms and Conditions <br />https:/Itechweb.stryker.com <br />Authorized Customer Signature <br />Printed Name <br />Title <br />Signature <br />Date <br />Attachment Stryker Quote Number 230321082506 <br />'Sales or use taxes on domestic (USA) deliveries will be invoiced in addition to the price of the goods and services on the Stryker Quote. <br />69 <br />