Page 28 - Demo

07/2014 Page 1 of 2
Job Number: Reference Number:
PURCHASER
Name: IKEA
Address: 4400 Shellmound St City: Emeryville
State: CA
Contact: Dwight Slaton Phone: 303 549-4623
Zip: 94608-2403
JOB LOCATION
Name: IKEA
Address: 4400 Shellmound St City: Emeryville
State: CA
Phone: 510 420-7004 Section(s):
Zip: 94608-2403
Per Proposal Dated: As per scope of work referenced in AP# 319962 Version: 319962.1.4 And/or as follows:
Purchase Price:
Purchase PO #:
Sales Rep: MICHAEL BRENNAN Office Location: Livermore, CA Phone: 510 921-5500
Bank Name: Address: Phone:
Trade References:
1. Trade Reference: Address:
2. Trade Reference: Address:
3. Trade Reference: Address:
Warranty to be issued in the name of: 1.
2.
Warranty Length/Yrs:
Payment Terms:
Purchaser to initial acknowledgement of Payment Terms: _______
DESCRIPTION OF WORK
SALES INFORMATION, PAYMENT TERMS and WARRANTY
PURCHASING CREDIT INFORMATION - REQUIRED
City:
City:
City:
Phone:
State: Zip: Phone:
State: Zip: Phone:
State: Zip:
Account #: Contact: City :
PURCHASER AUTHORIZATION AND ACCEPTANCE
By my signature below, I certify that I have authority to bind the Purchaser and have had the opportunity to review the terms of this Agreement, including those set forth on the second page attached hereto and incorporated herein. On behalf of the Purchaser, I understand and accept said terms and agree to be bound thereby; and acknowledge that a sample copy of the Warranty (if applicable) has been provided for my review. I also authorize the release of credit information to CentiMark Corporation.
Approved and accepted by Purchaser Printed Name and Title Date
SUBJECT TO THE FOLLOWING TERMS AND CONDITIONS ON SECOND PAGE __________ INITIAL PAGE 1