Zenex Purchase Order

7777 First Place
Cleveland, OH 44146
Phone: 440-232-4155 Fax: 440-786-7233

Purchase Order

Customer PO #		Date
BILL TO:
Name
Street		P.O. Box
City		State	Zip
Phone		Fax

Customer PO #		Date
SHIP TO:
Name
Street		P.O. Box
City		State Zip
Phone		Fax

Zenex Part Number	Qty	UOM	Product Name/Description	Cust Item #	Unit Price	Extended Price

Comments

Signature of Officer		Title
	Check this box to approve your typed name in the above signature box as your signature