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Hewlett Packard Attn Government Education Sales 10810 Farnam Drive by tam26166

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									                                  Government &                         Credit
                                  Education Sales                      Card Sales
                                                                       Form
                                                                                    Purchase Order
                                  Hewlett Packard                          Number
                                                                           C
                                  Attn: Government / Education Sales       C
                                  10810 Farnam Drive                Fax To:
                                  Omaha, NE 68154             1-800-205-4729
BILL TO INFORMATION                                             SHIP TO INFORMATION
Name                                                            Name
Address                                                         Address
Address                                                         Address
City, ST, Zip                                                   City, ST, Zip
Phone                                                           Phone
e-mail                                                          e-mail
                                             PARTS TO BE ORDERED

QTY                 PART NUMBER   DESCRIPTION                                       UNIT PRICE           EXTENDED PRICE




                                     See IDE quote for line Items                                    TOTAL
PAYMENT DETAILS
      Cash             Check         Credit Card
CREDIT CARD TYPE
      Visa                            CARDHOLDER NAME -
      Master Card                         CARD NUMBER -
      AMEX                                  EXPIRATION -
      Discover                                                      SHIPPING NOTES


             ORDER NOTES

								
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