North Bay Canoe Midwest Territory
205 7th St. NW, Bemidji, MN 56601
(218) 444-7777, Fax (218) 751- 4063
Purchase Order #
Date Ordered
Customer Name
Address
Phone
Fax
E-mail
Amount enclosed (10% down required - U.S. funds) $
Shipping required ( ) Yes ( ) No - Tax exempt? ( ) No: If yes, exemption #
Please supply the following items:
Item Description
Qty
Unit Cost
Total Amount
       
       
       
       
       
       
       
       
  Subtotal  
Shipping Charge  
Handling Charge  
Insurance  
(Mn tax rate 6.5%) Tax
  
Total Due  
Ordered by
Approved by
Special Instructions