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Billing statement-recurring

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					                                                            STATEMENT
Company LOGO
Company Name                                                                   Statement #:              1005
Company Contact                                                                Date:                     May 31, 2011
123 Street                                                                     Net Terms (Days):         90
Suite 100                                                                      Due Date:                 August 29, 2011
Seattle, WA 98119                                                              Billing Cycle:            Quarterly
Phone: 206.222.2222
Fax:     206.111.1111

TO:                                                                            FOR:
Customer Name                                                                  Service Parts
Customer Contact
333 Street
Suite 222
Houston, TX 77099

          Date                 Quantity         Part #         Description            Per Unit              Amount

  5/15/2011                        2           123-A          A Product Item                   $65.00         $130.00

  5/15/2011                        3           234-B          B Product Item                   $33.00           $99.00
  5/15/2011                        4           345-C          C Product Item                   $25.00         $100.00




                                                                                                 Total       $329.00

Make checks payable to:    Company Name
Payment is due on:         August 29, 2011

If you have any questions concerning this statement, please contact:
Company Name
Company Contact
Phone: 206.222.2222

				
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