AmeriForm - Manufacturer and Supplier

ORDER SUMARY

Requisition Number:	N/A
Placed:	09-06-2022
Order Status:	Delivered
Total for Addons:	$16.00
Total Order:	$659.01
Paid Alowance Balance:	$659.01
Pick up at Store?	No

EMPLOYEE INFORMATION

Employee #:	23569
Name:	LUIS A
Last name:	RINCON
Department:	Bus Operators
Allowance Balance:	$5.87

SHIPPING INFORMATION

Shipping date:
Delivery Date:
Shipping method:

CHANGE REQUISITION

New Number:

Order # 03011



Received	In Process	Shipped	Delivered

Shipping Address:

LUIS A RINCON

4427 Stradford Pl

San Antonio, TX 78217

United States

Phone: 323-251-9853

General Observations:

Product List:

Rothco Touch Screen Neoprene Duty Gloves

Brand: Rothco

Size: Medium

Quantity: 1

Color: Black

$19.59

ANSI 3 Reversible Police Raincoat w/hood

Brand: Liberty

Size: 3XL

Quantity: 1

Color: HI VIS/BLACK

$69.70

CornerStone® - Select Snag-Proof Tactical Polo

Brand: CornerStone

Size: 5XL

Quantity: 4

Color: Royal

Flag Addon: Texas Flag

Patch Addon: Union Patch

$28.37

OGIO® Metro Ballistic Pack

Brand: Ogio

Size: One Size

Quantity: 1

Color: Black

$72.00

GARRISON BELT

Brand: Dutyman

Size: 50

Quantity: 1

Color: Black

$25.48

Hi-Visibility Soft Shell Jacket - Class 3

Brand: Red Kap

Size: 4XL

Quantity: 1

Color: Yellow and Black

$89.44

Rothco Military And Public Safety Insoles

Brand: Rothco

Size: 11

Quantity: 1

Color: Black

$9.79

Rothco V-Max Lightweight Tactical Boot - 8 Inch

Brand: Rothco

Size: 11

Quantity: 1

Color: Black

$110.73

Horace Small Dutyflex Hidden Cargo Trouser

Brand: Horace Small

Waist: 40

Lenght: 28

Quantity: 2

Color: Navy

$66.40

ORDER SUMARY

EMPLOYEE INFORMATION

SHIPPING INFORMATION

CHANGE REQUISITION

Order # 03011

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