Delivery Form 1.Deliver Number:
 
SY2012322d
2.  Date: 3/22/2012
PO#   
    CLARK RIGGING 5.Shipped from  : SANY AMERICA INC.
318 COOPER CIRCLE                PEACHTREE CITY, GA 30269
Contact : PAUL / PARTS
Address 500 OHIO ST.                                          LOCKPORT, NY 14094 6.Ship to( if not same as item 4)  
Phone 716-433-4600 7.Payment    
8.Order type SALES (x )   TD  (    ) Gift (    ) RTN (     ) RLOC(     ) Adjust(     ) Show (     )
9.Order Detail
Parts number Description Unit Qty Unit price Amount
21024821 Switch     1 165.95 165.95
             
             
SUB TOTAL  165.95
  SHIPPED OUT FED GRD NO#         Freight  
Sale tax  
Total  
             
Warehouse Keeper Name   Service Dirctor: Name  
Signature   Signature