Network Resource Inc.

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Purchase Order Request Form

Please fill out this form for all items to be purchased. When placing an
order, the P.O. number is the name of the client.

*required fields


Company Name:*

Contact:*

Client Phone:*

Consultant Email:*

Shipping Charge (estimated):*

Markup Percentage:*

Purpose:*

Scheduled Purchase Date:*

From what Vendor :*

The last 4 digits of CC:*

List out items and associated costs:* Example: Planar 19" @ $289 Netgear 4 port Switch @ $43 etc.