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8855 Washington Blvd. Culver City, CA 90232 Ph.(310) 837-9100 Fax (310) 837-2187 e-mail [email protected]

QUOTATION WORKSHEET QUOTE NUMBER:

DATE:

CUSTOMER NAME: ADDRESS: CITY, STATE, ZIP: PHONE: FAX PHONE: ATTENTION:

BRANCH: Culver City SALES REP: Dan Veronin PHONE: 310-837-9100 CELL 310-895-5779 PRICING EXPIRES: 30 DAYS F.O.B.: TERMS: NET 30 DATE REQUIRED:

JOB NAME: QUANTITY

1

PART NUMBER

DESCRIPTION

VENDOR

PRICE/EA

FREIGHT Job Total --> $0.00 THANK YOU FOR THE OPPORTUNITY TO QUOTE THIS JOB! PRICES DO NOT INCLUDE ALL APPLICABLE TAXES AND FEES AS THEY MAY APPLY TO THIS SPECIFIC JOB ASK US ABOUT FINANCING & LEASE PROGRAMS ON AMERICAN STANDARD EQUIPMENT

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