Purchase Order
TRACKING #:
EV4444
DATE:
9/1/98
 
 
SHIPT TO: 
University of Illinois at Chicago M/C 154 
Rm 2032 Bldg 648 EVL 
c/o Central Receiving 
1524 S. Peoria 
Chicago, IL 60608		 VENDOR NAME & ADDRESS: 
 
VENDOR Name 
Alternate Ship to Name 
Address LIne 1 
Address Line 2 
Address Line 3 
City, State Zip Code 
40 charactors accross 6 lines down.
 
ALTERNATE SHIP TO: 
Alternate Ship to Name 
Address LIne 1 
Address Line 2 
Address Line 3 
City, State Zip Code 
40 charactors accross 6 lines down.
 
 		 FEIN#: 
numeric entry 9 digits
VENDOR FAX:

VENDOR PHONE:

VENDOR CONTACT:
 
 
 
 
ITEM CATALOG # DESCRIPTION TYPE QTY. UNIT PRICE AMOUNT

TOTAL AMOUNT