AmeriForm - Manufacturer and Supplier

ORDER SUMARY

Requisition Number:	N/A
Placed:	01-06-2026
Order Status:	Delivered
Total for Addons:	$16.00
Total Order:	$213.55
Paid Alowance Balance:	$213.55
Pick up at Store?	No

EMPLOYEE INFORMATION

Employee #:	30926
Name:	RAFAEL J
Last name:	ULLOA
Department:	Bus Operators
Allowance Balance:	$48.10

SHIPPING INFORMATION

Shipping date:
Delivery Date:
Shipping method:

CHANGE REQUISITION

New Number:

Order # 17454



Received	In Process	Shipped	Delivered

Shipping Address:

RAFAEL J ULLOA

3838 lockhill Selma rd Apt 627

San Antonio , TX 78230

United States

Phone: 9175397694

Product List:

Zone Performance T-Shirt

Brand: PrimePlus

Size: 3XL

Quantity: 1

Color: Royal Blue

$13.00

Sport-Tek® Sport-Wick® Fleece Full-Zip Hooded Jacket

Brand: Sport-Tek

Size: 3XL

Quantity: 1

Color: Navy

Flag Addon: US Flag

Patch Addon: Union Patch

$36.87

OTTO CAP 6 Panel Low Profile Baseball Cap

Brand: Otto

Size: Adjustable

Quantity: 1

Color: Navy

$13.91

CornerStone® - Select Long Sleeve Snag-Proof Tactical Polo

Brand: CornerStone

Size: 4XL

Quantity: 1

Color: Royal

Flag Addon: US Flag

Patch Addon: Union Patch

$30.50

Mens Softshell Jacket

Brand: Red Kap

Size: 4XL

Quantity: 1

Color: Black

Flag Addon: US Flag

Patch Addon: Union Patch

$74.05

CornerStone® - Select Snag-Proof Tactical Polo

Brand: CornerStone

Size: 4XL

Quantity: 1

Color: Royal

Flag Addon: US Flag

Patch Addon: Union Patch

$29.22

ORDER SUMARY

EMPLOYEE INFORMATION

SHIPPING INFORMATION

CHANGE REQUISITION

Order # 17454

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