| Bill To: | 3001 S US Hwy 287 Corsicana TX 75109 | Ship To: | |||
|---|---|---|---|---|---|
| PO#: | Store Name | Premier Rental Purchase | |||
| Rep Name: | Jeff Johnson | Attention: | Gerald | ||
| Rep Phone #: | 804-295-2220 | Address: | 5065 Fort Ave | ||
| PM Bank #: | – | Phone #: | |||
| Order Date: | October 16, 2024 at 12:45 pm | Requested Ship Date: | Specific Date – October 16, 2024 | ||
| Qty | Item # | Description | Product Price | Product Total |
|---|---|---|---|---|
| 5 | F005317 | F005317 – Symbol (Black) Foot Protector – Queen – | $39.94 | $199.70 |
| 5 | F005316 | F005316 – Symbol (Black) Bolster – Queen – | $33.26 | $166.30 |
| Please review Quantity | ||||
| Approved By: | ||||
| Order Total: $366.00 |