SEWP Credit Card Sales Form V1.00 07/09/07
Hewlett-Packard Company
Federal Program Office 6600 Rockledge Drive Bethesda, MD 20817 Sales: 800-727-5472 Order Date
ORDER STATUS
800-727-5472, Opt 2, Opt 2
SUBMIT ORDER TO:
email to sewphpsales@hp.com
Purchase Order Number
Reseller Name: Outlet ID #:
BILL TO INFORMATION Agency Attention Address City, ST, Zip Phone e-mail
SHIP TO INFORMATION Agency Attention Address City, ST, Zip Phone e-mail PARTS TO BE ORDERED
Same as Bill To
Purchasing Contract: NNG07DA17B
QTY PART NUMBER
ICC Quote # :
DESCRIPTION
Territory ISR:
UNIT PRICE EXTENDED PRICE
Subtotal
1 SEWP Z SEWP IV Surcharge
TOTAL $
-
-
ORDER SALES REP CREDIT CARD TYPE
Visa Mastercard Amex Discover
See ICC quote for line items
CARDHOLDER NAME CARD NUMBER EXPIRATION SHIPPING NOTES
ORDER NOTES
SEWP Credit Card Sales Form V1.00 07/09/07
Page 1
HP Federal Sales 2/26/2009