PURCHASE ORDER

DATE: ____________________	PURCHASE NUMBER: _________

TO: ________________________

____________________________

____________________________

____________________________

________________, desires to purchase the following on the terms

stated herein. TO ACCEPT THIS OFFER PLEASE RETURN THE ORIGINAL

SIGNED PURCHASE ORDER. ACCEPTANCES MUST BE ON THIS FORM.

Item: _____________________ Quantity:____(_______________)

Price per unit: $________ Tax: $__________

TOTAL: $_______ (____________________&___/100 dollars)

Shipping date: ______________ Shipping method: _____________

THIS PURCHASE ORDER IS SUBJECT TO THE TERMS AND CONDITIONS STATED

BELOW:

THE DATE STATED FOR SHIPPING IS A FIRM REQUIREMENT DATE. PURCHASE

ORDER IS VOIDED IF NOT SHIPPED WHEN SPECIFIED ABOVE.

The goods supplied must meet the following specifications:

__________________________________________________________________

________________ shall have ____ days from delivery to inspect a

representative sample of the goods delivered for conformity with

the specifications set forth above. Should the goods fail to

conform to the specifications stated above, ________________ shall

notify _______________________, who shall have ____ days to cure.

Should ______________________ fail to cure, the contract shall be

deemed to have been breached by ______________________.

TERMS FOR PAYMENT

________________ shall pay for the goods purchased on the

following terms:

_________________________________________________________________

As to any and all products listed above purchased under this

purchase order that require set up, assembly or installation,

______________________ shall provide the same, within ____ days

of delivery. Setup shall be in accordance with manufacturers

specifications. The cost of the same is included in the price

stated above.

ACCEPTANCE OF THIS OFFER SHALL ONLY BE ON THIS PURCHASE ORDER

FORM. ANY TERMS CONTAINED ON SHIPPING RECEIPTS, OR LANGUAGE

WITHIN THE MANUALS, OR ON THE CONTAINER ON WHICH THE GOODS ARE

SHIPPED, SHALL NOT BE OPERATIVE TO VARY THE TERMS OF THIS

AGREEMENT.

BY: __________________________________

_____________________________________________

ACCEPTED BY _________________________________

BY:

____________________________________________

INSTRUCTIONS TO RECIPIENT:

Please return a signed copy of this purchase order to :

____________________________________________

____________________________________________

____________________________________________

This purchase order will then be forwarded to accounts payable

for approval and payment.