| Bill To: | Purple | Ship To: | |||
|---|---|---|---|---|---|
| PO#: | Ft Sam Houston: | Store Name | Ft Sam Houston: | ||
| Rep Name: | Paul | Attention: | Maria Lind | ||
| Rep Phone #: | 111-111-1111 | Address: | 213 Longhorn Way | ||
| PM Bank #: | – | Phone #: | 210-708-9234 | ||
| Order Date: | October 28, 2025 at 11:21 am | Requested Ship Date: | Standard Lead Time – | ||
| Qty | Item # | Description | Product Price | Product Total |
|---|---|---|---|---|
| 2 | F009544 | F009544 – 2024 Purple (Essential) Foot Protector – Queen – | $55.04 | $110.08 |
| 2 | F009547 | F009547 – 2024 Purple (Premium) Foot Protector – Queen – | $74.54 | $149.08 |
| Please review Quantity | ||||
| Approved By: | ||||
| Order Total: $259.16 |