Technical information

12
ORTIZ LABORATORY SUPPLIES ORDER FORM
DATE
VENDOR NAME
VENDOR TELEPHONE
OR URL
ITEM NAME
ITEM NUMBER
PRICE
(IF OVER $200 OBTAIN
AUTHORIZATION FROM C.
ORTIZ)
QUANTITY
UNIT
(e.g. gallon, pack of 12, etc.)
DATE NEEDED
ACCOUNT NUMBER
ADDITIONAL
COMMENTS
Please send to Tim Doyle ([e-mail]) or drop off to Room 12-099.
Call if you have questions (3-6819).