AmeriForm - Manufacturer and Supplier

ORDER SUMARY

Requisition Number:	N/A
Placed:	11-06-2022
Order Status:	Delivered
Total for Addons:	$8.00
Total Order:	$455.91
Paid Alowance Balance:	$455.00
Pending before Tax:	$0.91
Total tax:	$0.08
Total Paid after Tax	$0.99
Pick up at Store?	No

EMPLOYEE INFORMATION

Employee #:	21680
Name:	RAY A.
Last name:	GARCIA
Department:	Bus Operators
Allowance Balance:	$176.99

SHIPPING INFORMATION

Shipping date:
Delivery Date:
Shipping method:

CHANGE REQUISITION

New Number:

Order # 03779



Received	In Process	Shipped	Delivered

Shipping Address: Change

RAY A. GARCIA

5603 RUSHHILL ST

SAN ANTONIO, TX 78228

United States

Phone: 2102607863

Product List:

100% Cotton - Structured Firm Front Panel Low-Fitting

Brand: Otto

Size: Adjustable

Quantity: 1

Color: Navy

$12.00

New Dimension® Plus 6 Pocket Cargo Short

Brand: Horace Small

Waist: 44

Lenght: 10

Quantity: 4

Color: Navy

$46.97

Rothco Athletic Crew Socks

Brand: Rothco

Size: 10 - 13

Quantity: 2

Color: Black

$3.91

CornerStone® - Select Long Sleeve Snag-Proof Tactical Polo

Brand: CornerStone

Size: 3XL

Quantity: 1

Color: Royal

Flag Addon: US Flag

$29.61

OGIO® - Carbon Pack

Brand: Ogio

Size: One Size

Quantity: 1

Color: Black

$36.90

Rothco Tactical Cover Up Sleeves

Brand: Rothco

Size: L/XL

Quantity: 1

Color: Midnight Navy

$11.75

Rothco Forced Entry Tactical Waterproof Boot

Brand: Rothco

Size: 12

Quantity: 1

Color: Black

$68.59

Port & Company® - Knit Cap

Brand: Port and Company

Size: One Size

Quantity: 1

Color: Navy

$8.25

CornerStone® - Select Snag-Proof Tactical Polo

Brand: CornerStone

Size: 3XL

Quantity: 3

Color: Royal

Flag Addon: US Flag

$28.37

ORDER SUMARY

EMPLOYEE INFORMATION

SHIPPING INFORMATION

CHANGE REQUISITION

Order # 03779

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Company Information

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