EBS-Scantracker Purchase Order Form


Quantity	Item No.	Item Description	Unit Price	Total Price




Machine Make: _______________ Machine Model: _____________________ Payment Information [ ] Credit card by Fax (Fax: 913-384-5599) [ ] Master Card [ ] Visa [ ] American Express [ ] Discover Card Number: _______________________________________ Expiration Date: ___________ CVC Code: ____________ Cardholder Name (If different): _______________________________ Checks accepted by mail, fax, or phone U.S. Funds only, please Please remit to: aroundtheoffice.com- ATTN: Accounts Payable 3021 Merriam Lane, Kansas City, KS, 66106			Subtotal
			Shipping	U.S. $7.25 *
				CANADA $25.00 *
				INTERNATIONAL $25.00 *

			Total




Signature : X_______________________ Date : __________			* Most supply orders ship for $7.25 (U.S.) $25.00 (Canada) and $25.00 (International). We will call you if your order will cost more to ship before we process your check or credit card.