AmeriForm - Manufacturer and Supplier

ORDER SUMARY

Requisition Number:	U21-1287
Placed:	10-14-2021
Order Status:	Delivered
Total for Addons:	$12.00
Total Order:	$492.35
Paid Alowance Balance:	$492.35
Pick up at Store?	No

EMPLOYEE INFORMATION

Employee #:	22422
Name:	JOHN A.
Last name:	GARCIA
Department:	Maintenance
Allowance Balance:	$1.69

SHIPPING INFORMATION

Shipping date:
Delivery Date:
Shipping method:

CHANGE REQUISITION

New Number:

Order # 00170



Received	In Process	Shipped	Delivered

Shipping Address: Change

JOHN A. GARCIA

4319 redcap dr

San antonio, TX 78222

United States

Phone: 2104656144

Product List:

Enhanced Visibility Industrial Work Shirt

Brand: Red Kap

Size: XL

Quantity: 2

Color: Navy

Flag Addon: Texas Flag

Patch Addon: Union Patch

$37.29

AUGUSTA MOISTURE WICKING SHIRT

Brand: Augusta SportsWear

Size: XL

Quantity: 2

Color: Navy

$11.82

MENS INDUSTRIAL 65/35 L/S WORK SHIRT

Brand: Red Kap

Size: XL

Quantity: 1

Color: Navy

Flag Addon: Texas Flag

Patch Addon: Union Patch

$15.74

REDKAP INDUSTRIAL CARGO PANT

Brand: Red Kap

Waist: 38

Lenght: 28

Quantity: 4

Color: Navy

$24.50

Jerzees Adult DRI-POWER® ACTIVE Pocket T-Shirt

Brand: Jerzees

Size: Large

Quantity: 5

Color: Navy

$11.82

Belt, 1 1/2

Brand: Dutyman

Size: 42

Quantity: 1

Color: Black

$18.38

MP NAVY WESTERN JEAN

Brand: Red Kap

Waist: 40

Lenght: 28

Quantity: 5

Color: Navy

$20.57

BAGedge Tech Backpack

Brand: Bagedge

Size: One Size

Quantity: 1

Color: Black

$39.90

Rothco Athletic Crew Socks

Brand: Rothco

Size: 10 - 13

Quantity: 4

Color: Black

$3.91

Port Authority® Flexfit® Cotton Twill Cap

Brand: Port Authority

Size: S/M

Quantity: 3

Color: Navy

$10.84

ORDER SUMARY

EMPLOYEE INFORMATION

SHIPPING INFORMATION

CHANGE REQUISITION

Order # 00170

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