8211 NW 64 Street. Bay # 7   Miami, FL 33166
Phone: (305) 597-9002  Fax: (305) 597-9003

E-mail: pittk@aol.com


                            QUOTATION  FORM

Customer Number

Order date

Organization

Purchase Order #

Ship to Address

Payment terms

Address (cont.)

Phone

City

FAX

State/Province

E-mail

Zip/Postal Code

Country

Please provide the following ordering information:

REFERENCE

TERMS

VALIDITY

C.O.D.

30 DAYS

 

ITEM

QTY

DESCRIPTION

UNIT PRICE

TOTAL AMOUNT