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tp F AR" SERVICE <br />SURE "I��IRON RD <br />2�e" IN CITY OR 9744 <br />JU <br />541 998 1121 <br />hant ID• 0702179 <br />M <br />Terra ID: 0413 <br />Sale <br />MRSTERCflRD c,�� <br />XXXXXXXXXXXX <br />Entry Method. Sllip�atchat p00848 <br />Wrvd:Online 11;22;46 per <br />81i11A1 <br />DELIVERY SLIP/ BILL OF LADING <br />CASH I CHG RETURN <br />DATE r f <br />SHIP TO <br />APPLICATOR NO. <br />PURCHASE ORDER NO. <br />j Sure Crop Farm Service <br />28410 Milliron Road <br />Junction City, Oregon 97448 <br />(541) 998 -1121 <br />FAX 998 -1620 <br />W-C. b Vyjuv+ „ - <br />COMMODITY <br />Customer co <br />TNAt1K YOUt <br />� C1 <br />ITEM CODE <br />PRICE <br />TOTALS <br />This is to certify that the above named materials are properly classified, described, I certify that: 1) 1 have read this invoice and In consideration of this sale, agree to the <br />packaged, marked and labeled, and are In proper condition for transportation, according terms thereof: 2) 1 have been offered for display on my vehicle, four <br />to the applicable regulations of the Department of Transportation. placards. <br />Sure Crop Farm Service SHIPPER By G- Signed <br />IMPORTANT NU IFIC ; VIN ISAL A <br />