HomeMy WebLinkAboutCORRESPONDENCE - PURCHASE ORDER - 91521199
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Bill To: 65084674
Terri Runyan
City of Fort Collins
300 Laporte Ave
Fort Collins CO 80522
INVOICE
Order Number . 7000710218
Today's Date "07/2015
Ship To: 65094674
Terri Runyan
City of Fort Collins
300 Laporte Ave
Fort Collins CO 80522
Page I of 1
Payment Terms NET30
Due Date 05/0712015
Invoice No / Invoice Date
Unit
Product
Status
City Unit Price
Diarmmt Coupon
Adjustment Total
0095064307 / 4r7/2015
1.211622-Baldrige Application Fees
Active
1 18,000.00
0.00 0.00
0.00 18,000.00
Shipping
0,00
Tax.
0.00
Order Total
18,000.00
Paid to Date:
0,00
Current Amount Due:
I8,000 00
L7Vendor/Sku)P!PAW0'
h #
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,j o 3.50C�
Please detach the lower portion and retum it with your payment Thank you for your order
CUSTOMER NO. 65084674 ORDER NO 7000710218 BALANCE DUE_ S 18,000,00
CUSTOMER NAME Tern Runyan
PAYMENT AMT. ❑ Check or Money rder made payable to AS (U. S.dollars drawn on a U.S. bank)
CCA
❑ American Express u Master Card Visa
Card Expiration Date
Cardholder's Name(Please Print):
Cardholder's Signature
Cardholder's Billing Address(Ifi ifferent than above)_
Remit Payments to: ASQ, Amounts Receivable, P.O. Box 555, Milwaukee, WI 53202