PURCHASE ORDER Addressee Name: Address: City, Country, Zip Code: Phone: Fax. / Email: L A T O T E C I R P N O I T P I R C S E D R E B M U N T R A P y e l l u P r e v i r D 1 2 0 0 - 0 0 6 0 162,00 y e l l u p n e v i r D 1 7 1 0 - 0 0 6 5 98,00 e g n a l F d e x i F 9 2 0 0 - 5 0 6 0 62,00 e g n a l F d e x i F 1 3 0 0 - 5 0 6 5 45,00 e g n a l F g n i d i l S 5 1 0 0 - 0 1 6 0 60,00 e g n a l F g n i d i l S 1 0 0 0 - 0 1 6 5 30,00 0080-0177 Washer 5,00 0650-1001 Spring Support 5,00 0080-0603 Washer 1,00 0080-0613 Washer 5,00 0540-3002 Spring Cover 5,00 C15 Internal snap ring 1,00 0115-0052 D1 Cap 25,00 0080-0169 Lock washer 1,00 X-1520 Lock Nut 2,50 0130-3012 Block 5,00 ASA-1 Washer 1,00 5620-2006 Cam 25,00 ASK-5 Square key ¼ 1,00 0080-0220 Snap Ring 1,00 5630-3001 Cam Shoe 1,50 calibration 0651-1100 Driver Pulley Spring (white / green / pink) 16,00 0551-1119 Driver Pulley Spring (silver / pink / yellow) 16,00 5051-1015 Driven Pulley Spring (orange / silver / yellow) 16,00 0135-3065 Weight (275g) 5,50 BD52-2167-S Belt 39,20 BD52-2172-S Belt 39,20 BD52-2179-S Belt 39,20 BD52-2183-S Belt 39,20 KE52-2205-S Belt 39,20 Sub-total Approved by : Taxes Total Shipping FedEx companies: UPS DHL Dicom Purolator Account # : Payment by credit card : VISA MASTERCARD Credit Card Number 3-digit number (on back side) Expiration Date (month / year) (Note: the credit card must be valid for at least 6 months after the request date) Signature Date All prices are in Canadian $ Important note: CVTech-AAB will use only the shipping companies listed here. We also provide a «Collect» service. QUANTITY 3037, boulevard Frontenac Est Thetford Mines, Qc, G6G 6P6, Canada Phone: 418-335-7220 Toll Free: 1-800-518-7220 Fax: 1-866-418-4786 MiniBaja PROJECT

CVTech-AAB MiniBaja Order 2012 - rev 2 · PART NUMBER DESCRIPTION PRICE TOTAL 0600-0021 Driver Pulley 162,00 5600-0171 Driven pulley 98,00 0605-0029 ... 0080-0169 Lock washer 1,00

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Page 1: CVTech-AAB MiniBaja Order 2012 - rev 2 · PART NUMBER DESCRIPTION PRICE TOTAL 0600-0021 Driver Pulley 162,00 5600-0171 Driven pulley 98,00 0605-0029 ... 0080-0169 Lock washer 1,00

PURCHASE ORDER

Addressee

Name:

Address:

City, Country, Zip Code:

Phone:

Fax. / Email:

LATOTECIRPNOITPIRCSEDREBMUN TRAP

yelluP revirD1200-0060 162,00yellup nevirD1710-0065 98,00egnalF dexiF9200-5060 62,00egnalF dexiF1300-5065 45,00egnalF gnidilS5100-0160 60,00egnalF gnidilS1000-0165 30,00

0080-0177 Washer 5,000650-1001 Spring Support 5,000080-0603 Washer 1,000080-0613 Washer 5,000540-3002 Spring Cover 5,00C15 Internal snap ring 1,000115-0052 D1 Cap 25,000080-0169 Lock washer 1,00X-1520 Lock Nut 2,500130-3012 Block 5,00ASA-1 Washer 1,005620-2006 Cam 25,00ASK-5 Square key ¼ 1,000080-0220 Snap Ring 1,005630-3001 Cam Shoe 1,50

calibration0651-1100 Driver Pulley Spring (white / green / pink) 16,000551-1119 Driver Pulley Spring (silver / pink / yellow) 16,005051-1015 Driven Pulley Spring (orange / silver / yellow) 16,000135-3065 Weight (275g) 5,50

BD52-2167-S Belt 39,20BD52-2172-S Belt 39,20BD52-2179-S Belt 39,20BD52-2183-S Belt 39,20KE52-2205-S Belt 39,20

Sub-totalApproved by : Taxes

TotalShipping FedEx

companies: UPSDHLDicomPurolator

Account # :

Payment by credit card :

VISA MASTERCARD

Credit Card Number 3-digit number (on back side) Expiration Date (month / year)(Note: the credit card must be valid for at least 6 months after the request date)

Signature Date

All prices are in Canadian $

Important note: CVTech-AAB will use only the shipping companies listed here.We also provide a «Collect» service.

QUANTITY

3037, boulevard Frontenac EstThetford Mines, Qc, G6G 6P6, CanadaPhone: 418-335-7220 Toll Free: 1-800-518-7220Fax: 1-866-418-4786

MiniBaja PROJECT