SAMPLE

Bloomington Controls
xkkCustomer Order Acknowledgement%%%
(Invoice)

Today 's Date:
Date Received:
(Invoice No.):.

Sold To:

Ship To:

Shipping Instructions:
Packing Insturctions:

Discount: : Promised Shipment Date:
Customer P.O. No.: Agent/Salesman No.:
Catalog No. Part No. Desc. Oty. Price Discount
(Freight)
Exhibit 1

Total