AmeriForm - Manufacturer and Supplier

ORDER SUMARY

Requisition Number:	U21-1193
Placed:	10-08-2021
Order Status:	Delivered
Total for Addons:	$4.00
Total Order:	$311.83
Paid Alowance Balance:	$311.83
Pick up at Store?	No

EMPLOYEE INFORMATION

Employee #:	7719
Name:	DANIEL
Last name:	MENDOZA
Department:	Bus Operators
Allowance Balance:	$791.33

SHIPPING INFORMATION

Shipping date:
Delivery Date:
Shipping method:

CHANGE REQUISITION

New Number:

Order # 00082



Received	In Process	Shipped	Delivered

Shipping Address: Change

DANIEL MENDOZA

8239 Shumerd Oak Dr

San Antonio, TX 78223

United States

Phone: 2106850855

Product List:

Mens Softshell Jacket

Brand: Red Kap

Size: 4XL

Quantity: 1

Color: Black

Flag Addon: Texas Flag

$66.70

ANSI 3 Reversible Police Raincoat w/hood

Brand: Liberty

Size: 2XL

Quantity: 1

Color: HI VIS/BLACK

$66.70

Rothco Touch Screen Neoprene Duty Gloves

Brand: Rothco

Size: Medium

Quantity: 1

Color: Black

$19.59

Rothco Athletic Crew Socks

Brand: Rothco

Size: 10 - 13

Quantity: 5

Color: Black

$3.91

CornerStone® - Select Snag-Proof Tactical Polo

Brand: CornerStone

Size: 4XL

Quantity: 1

Color: Royal

Flag Addon: Texas Flag

$25.05

Mens New Generation® Stretch 4-Pocket Trouser

Brand: Horace Small

Waist: 50

Lenght: 27

Quantity: 1

Color: Navy

$66.15

New Dimension® Plus 6 Pocket Cargo Short

Brand: Horace Small

Waist: 28

Lenght:

Quantity: 1

Color: Navy

$44.09

ORDER SUMARY

EMPLOYEE INFORMATION

SHIPPING INFORMATION

CHANGE REQUISITION

Order # 00082

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