AmeriForm - Manufacturer and Supplier

ORDER SUMARY

Requisition Number:	N/A
Placed:	08-06-2025
Order Status:	Delivered
Total for Addons:	$12.00
Total Order:	$186.90
Paid Alowance Balance:	$186.90
Pick up at Store?	No

EMPLOYEE INFORMATION

Employee #:	26533
Name:	EZEKIEL
Last name:	GALLOWAY
Department:	Bus Operators
Allowance Balance:	$103.28

SHIPPING INFORMATION

Shipping date:
Delivery Date:
Shipping method:

CHANGE REQUISITION

New Number:

Order # 15122



Received	In Process	Shipped	Delivered

Shipping Address:

EZEKIEL GALLOWAY

2927 RUIZ STREET

SAN ANTONIO, TX 78228

United States

Phone: 2107817936

Product List:

100% Cotton - Structured Firm Front Panel Low-Fitting

Brand: Otto

Size: Adjustable

Quantity: 1

Color: Navy

$12.36

Augusta Unisex Nylon Coach Jacket

Brand: Augusta SportsWear

Size: 4XL

Quantity: 1

Color: Black

Flag Addon: Texas Flag

Patch Addon: Union Patch

$22.27

OTTO CAP 6 Panel Low Profile Baseball Cap

Brand: Otto

Size: Adjustable

Quantity: 1

Color: Navy

$13.91

ANSI 3 Reversible Police Raincoat w/hood

Brand: Liberty

Size: 4XL

Quantity: 1

Color: HI VIS/BLACK

$71.79

Harriton Men Easy Blend™ Short-Sleeve Twill Shirt with Stain-Release

Brand: Harriton

Size: 4XL

Quantity: 1

Color: French Blue

Flag Addon: Texas Flag

Patch Addon: Union Patch

$25.35

CornerStone® - Select Snag-Proof Tactical Polo

Brand: CornerStone

Size: 4XL

Quantity: 1

Color: Royal

Flag Addon: Texas Flag

Patch Addon: Union Patch

$29.22

ORDER SUMARY

EMPLOYEE INFORMATION

SHIPPING INFORMATION

CHANGE REQUISITION

Order # 15122

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