FORM OF PURCHASE
COMPANY INFORMATION
Trade Name
*
RUT (Company)
*
Customer Code
Country
*
City
*
Port Destination
Date Order
día
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
mes
01
02
03
04
05
06
07
08
09
10
11
12
año
2006
2007
Fax
*
Method of buying
1) Withdrawal of the product at the port
2) Withdrawal in cellars (includes all custom)
3) Service home delivery
PRODUCTS
Units
EUTROFIT (pack 25 lt.)
ORGAZOT (sack 20 kg.)
ORGAZOT S (sack 20 kg.)
Contact
(Responsible for overall relations with LOFERZUL S.A)
Name
*
Surname
*
Phone
*
Fax
Post
e-mail
*
Form of payment
Bank Transfer
