Word Purchase Order

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PURCHASE ORDER Please complete all fields except the lines in section 5 that you do not need. See page 2 for completion instructions. 1 Supplier: 2 Customer Purchase Order: Mineral Springs Bottling Co., Inc. PO Box 370, 530 King Street Petersburg, PA 16669 800-822-2614 3 Bill To: Company Contact Address 1 Address 2 PO Number: ASI No: Date: Fax: 484-229-9152 4 Ship To: City Phone ST Fax Zip Code City/ST/Zip Phone/Fax City Phone ST Fax Zip Code Order Notification Email Address: (This email address will be used for all correspondence during the order fulfillment process) 5 Order Details: # 01 02 03 04 05 06 07 Quantity Item & Description Unit Price Total Price Bottle line item #1 (required)…………… Bottle line item #2 (optional).…………... Setup / Rerun Service (required)……... Additional Services #1 (optional)………. Additional Services #2 (optional)………. Additional Services #3 (optional)………. Other (optional)………………………….. Subtotal (before Shipping)……………… Select Bottle Size / Cap Style: Select Bottle Size / Cap Style: Please Select One: Optional Service 1: Optional Service 2: Optional Service 3: Enter "Other" description here $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 (Shipping costs will be estimated on the Order Agreement you receive after your order is submitted) 6 Shipping Details: (please see instructions for explanation of each item below) IN-HANDS DATE: EARLIEST DELIVERY DATE: LATEST DELIVERY DATE: RECEIVING HOURS M-F: S-S: LOADING DOCK? FORKLIFT? RESIDENTIAL DELIVERY? CONVENTION CENTER? INSIDE DELIVERY? YES YES YES YES YES NO NO NO NO NO 7 Authorization: (This is a binding contract between Customer and Manufacturer. The Authorized Buyer attests by the typewritten or hand written name below that he/she can enter into contracts on behalf of the “Bill To” company. Terms: Net 15 days. Buyer authorizes Manufacturer to charge the credit card on file on the credit application if order is unpaid 30 days after invoice date.) AUTHORIZED BUYER Please check here TITLE DATE if this your first order with Mineral Springs, then complete the credit application on page four. PURCHASE ORDER COMPLETION AND SUBMISSION INSTRUCTIONS Mineral Springs requires that customers submit purchase orders before production can be scheduled. This provides the necessary information to help us process your order quickly and accurately. If you do not have your own purchase order form, we have made a generic form available for your use. In just a few steps, you can download the form to your computer, fill out the form using Microsoft Word, print and save the form and then email it to the Mineral Springs order processing department. PURCHASE ORDER COMPLETION AND SUBMISSION INSTRUCTIONS: 1) Download the Microsoft Word Purchase Order document (Purchase Order.doc) from the Mineral Springs web site (www.mineralsprings.com/form_library.htm) to your computer. 2) Open the document in Microsoft Word. 3) The Purchase Order form is a protected document. This means you can only enter data in the designated fields, i.e. the ones that are highlighted. 4) If there is already text in a highlighted field, this is just help text. Please type over the help text. For example, “City”, “ST” and “Zip Code” are meant to be overridden with your specific billing and shipping address information. 5) In the Order Details section, lines 01 and 03 are required and the remaining rows are optional. When you use a line, please note that the “Item and Description” field on rows 01 through 06 is a drop-down list field. When the cursor is on this field, a downward-pointing arrow will appear to the right of the field. Please click on the arrow and choose one of the values in the list. The row 07 Item and Description field is a simple text-entry field. If you use this line, simply type over the help text. 6) You must enter a Quantity and Unit Price for each line you use in the Order Details section. If you do not know the correct Unit Price, please refer to your Mineral Springs catalog or contact our Customer Service department at 800-822-2614. 7) When you finish filling out the form, save the document to your computer and print the document. The Total Price column will not calculate until you print the document. 8) Attach the document to an email and send to order@mineralsprings.com. FIELD HELP BY SECTION 2 Customer Purchase Order:    PO Number – your purchase order number Date – the date you prepare the purchase order ASI No. – your Advertising Specialty Institute member number; if you are not an ASI member, please enter “N/A” 5 Order Details:      Lines 01 & 02 / “Bottle Line Item” / Quantity – enter the number of bottles you wish to purchase; the quantity must be an even multiple of 24 as there are 24 bottles per case. Lines 01 & 02 / “Bottle Line Item” / Item & Description – click the down-arrow and choose the bottle size and cap style you wish. Lines 01 & 02 / “Bottle Line Item” / Unit Price – enter the bottle unit price for the corresponding bottle size / cap style from your Mineral Springs catalog. Line 03 / “Setup–Rerun” / Quantity – usually “1” Line 03 / “Setup–Rerun” / Item & Description - click the down-arrow and choose “Setup” or “Rerun” (Rev 0602) Purchase Order Completion and Submission Instructions    Line 03 / “Setup–Rerun” / Item & Description - check your Mineral Springs catalog for the respective price Lines 04, 05, 06 / “Additional Services” – these are optional art, special handling and shipping services; please contact Customer Service if you have any questions. Line 07 / “Other” – please enter any other product or service not found on another line 6 Shipping Details:          In-Hands Date – your preferred delivery date (this cannot be guaranteed unless you choose a Guaranteed Delivery service. This is an additional cost. Earliest Delivery Date – the very earliest date you can receive your order Latest Delivery Date – the very latest date you can receive your order Receiving Hours – the time range you are available to receive deliveries on Monday thru Friday and Saturdays and Sundays, respectively Loading Dock? – does the delivery location have a loading dock that will accommodate a full size tractor-trailer (56‟ length)? Forklift? – does the delivery location have a forklift to unload the truck? Residential Delivery? – is the delivery location a private residence? Note – if your business is run out of a private residence, it is Residential Delivery! Convention Center? – is the delivery location a convention center? Inside Delivery? – if you do not have a loading dock, the product will be unloaded to the ground immediately behind the truck; choose „Yes‟ if you need the product moved inside your building (additional cost applies). 7 Authorization:     Authorized Buyer – full name of the person authorized to enter into purchase contracts for the Customer; a typewritten name is the same as a signature. Title – business title of the authorized buyer. Date – the date the purchase order is authorized. First Order – please check this box if this is your first order with Mineral Springs, then complete the Credit Application on page two. Purchase Order Completion and Submission Instructions (Rev 0602)

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