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~ ~ No. _ _ _ _ <br /> . , Date <br /> ' 47 West 5th Customer P.O. No. <br /> Eugene, Oregon 97401 <br /> _ Phone: (541) 342-3624 <br /> ` ~ J Fax: (541) 345-3286 <br /> <br /> QUANTITY DESCRIPTION AMOUNT <br /> _ <br /> _ , <br /> _ ..~''a.',~t7 t.. tai t{ :'I? V:1~U(7i ~ _'.`S.~ ti.. r us:: j:13r _ JI .i3.~. ~ ~ <br /> f.t)i+af il~r?+ir . <br /> j~~ to D to ~ <br /> To: ~J <br /> Job No. <br /> Contr No. <br /> Assessable? YES or <br /> !approve this for payment. <br /> Signature Date• <br /> >>-2~- <br /> •49 IN SUB 1~ <br /> _ .•~t it s 9 ~ <br /> _ - ..v <br /> ~ SHIPPING <br /> u~at~t Ili for tour business" TOTAL <br /> <br />