AmeriForm - Manufacturer and Supplier

ORDER SUMARY

Requisition Number:	U21-1839
Placed:	12-09-2021
Order Status:	Delivered
Total for Addons:	$22.00
Total Order:	$482.39
Paid Alowance Balance:	$482.39
Pick up at Store?	No

EMPLOYEE INFORMATION

Employee #:	9828
Name:	MASON R.
Last name:	ROBERTS
Department:	Bus Operators
Allowance Balance:	$0.00

SHIPPING INFORMATION

Shipping date:
Delivery Date:
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CHANGE REQUISITION

New Number:

Order # 00673



Received	In Process	Shipped	Delivered

Shipping Address: Change

MASON R. ROBERTS

11107 Creek Eagle

San Antonio, TX 78245

United States

Phone: 3107494121

Product List:

ANSI 3 Reversible Police Raincoat w/hood

Brand: Liberty

Size: 3XL

Quantity: 1

Color: HI VIS/BLACK

$69.70

Hi-Visibility Soft Shell Jacket - Class 3

Brand: Red Kap

Size: 3XL

Quantity: 1

Color: Yellow and Black

Flag Addon: US Flag

$83.35

Rothco Uniform Hi-Gloss Oxford Dress Shoe

Brand: Rothco

Size: 12

Quantity: 1

Color: Black

$58.79

ESSENTIAL V-NECK ACRYLIC VEST

Brand: Edwards

Size: 3XL

Quantity: 1

Color: Navy

$28.24

Mens Sentry Dress Trouser

Brand: Horace Small

Waist: 42

Lenght: 31

Quantity: 3

Color: Navy

$36.75

Augusta Unisex Nylon Coach Jacket

Brand: Augusta SportsWear

Size: 3XL

Quantity: 1

Color: Black

Flag Addon: US Flag

Patch Addon: Union Patch

$21.62

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

Brand: Harriton

Size: 3XL

Quantity: 4

Color: French Blue

Flag Addon: US Flag

Patch Addon: Union Patch

$22.11

ORDER SUMARY

EMPLOYEE INFORMATION

SHIPPING INFORMATION

CHANGE REQUISITION

Order # 00673

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