Material Quote Form & Purchase Order Form-printable order form providing a visitor or client an opportunity to request a quote and submit an order for a specific requirement. Your visitor will need to provide the following information:

· company's name,

· contact name,

· address,

· telephone #,

· fax #,

· e-mail

· Ship to address

· Purchase Order #

· Work Order #

· Date

· Customer PO# /Job #

· Quantity Ordered

· Quantity Shipped

· Description

· Unit Cost Total Cost

· Authorized Signature

· Vendor Acceptance Signature / Title

· Date

· Shipping Date

Please confirm this sheet with the appropriate information above to confirm receipt and acceptance of this Purchase Order.

KLEAR Electrical Corp. 42-21 West 24th Street
Long Island City, NY 11101
Telephone (718) 361-5366-Fax: (718) 361-2828

9. Resource Links: To Follow-Links will be offered by KLEAR and updated upon request.

Gary B. Gerome________________________________________ Date____________
President

Ira S. Ketive____________________________________________ Date____________
Vice President