Bulk Grains

Puetz Processing Purchase Order (ordering instructions)

FROM:	(billing address)	DATE:	PO#:
Name:
Box:		TO:
Address:			PUETZ PROCESSING
City:			P.O. BOX 3069
Province:			HUMBOLDT,SASK.CDA.
Postal or Zip Code:			S0K 2A0
Tel:			PH:/FAX 306 682-3520
Fax:
Email:		email:	drpuetz@sasktel.net

Product	Pack req'd	Qnty	Certif. Req.	Ship date req.	Price U.S.$	TOTAL VALUE

Carrier Name: Carrier Phone:

Please Calculate Your Order Total:	Subtotal	$
add shipping charges FOB Humboldt ::	Call or email for shipping charges	$
Please apply applicable tax:	Tax 1::	$
	Tax 2:	$
	Total Charges	$

Enter method or payment:

Terms:		Prepaid
		By Cheque # ___________________
		Net ____ days - authorization required.

Please sign if Faxing PO: _______________________________
Authorized Signature

Enter your shipping information: (if different form above address)

Name (Ship to):
Shipping Address:
Daytime Phone Number:
Email Address:

If for some reason you need to cancel this order, email us immediately at drpuetz@sasktel.net with CANCEL ONLINE ORDER in the subject line. You will be charged for orders already shipped.

Thank you for your order from Puetz Processing Online