52-107
TERMS
30 DAYS NET
REMIT TO
ORDER AND REQUISITION NO.
DATE ENTERED
SHIPPED VIA
INVOICE DATE
OUR INVOICE NO.
11-25-62
REFER ALL CORRESPONDENCE TO:
SOLD TO
SAME AS ADDRESS BELOW UNLESS INDICATED
SHIPPED TO
LAI
We hereby certify that these goods were produced in compliance with all applicable requirements of Section 6, 7 and 12 of the Fair Labor Standards Act, as amended, and of regulations and orders of the U. S. Department of Labor issued under Section 14, thereof
Returnable containers are charged and must be paid for. Full price of returnable containers will be credited provided they are received in good condition, freight prepaid, tagged with shipper's name.
OUR INVOICE NO.
CUSTOMER'S ORDER AND REQUISITION NO.
SPECIAL INSTRUCTIONS
F. O. B.
S/P
QUANTITY SHIPPED
CATALOG NUMBER
DESCRIPTION
UNIT PRICE
PAY LAST AMT. IN THIS COL.
2
100g Onalyl Chloride
18.90
37.80
2
100g Dimethylamine
4.90
2
100g Chloroform
7.75
ORIGINAL INVOICE
SEE OTHER SIDE FOR TAX REGISTRATION NUMBERS