PACKING SLIP
TAKEN BY
SERIAL NO.
SPECIAL INSTRUCTIONS
CREDIT
ESTIMATE APPROVED BY
DATE
BROCK TOOL
NO CLAIMS OR RETURNS ALLOWED AFTER 6 DAYS OF RECEIPT OF SHIPMENT WITHOUT AUTHORIZATION
FREIGHT CHARGES
NO. R-
NAME
NEW TOOL BROCK WARRANTY WARRANTY TELEPHONE NUMBER
CUSTOMER CLAIM TICKET
GIVE ESTIMATE
VOLTAGE
TOOLS NOT CLAIMED IN 30 DAYS WILL BE SOLD FOR CHARGES.
TYPE
ALL ESTIMATES MUST BE REPLIED TO IN 10 DAYS.
P/C 0 9 6 19PER 288 377 46DISC. 555 644 73 PARTS 3 822 911 090 189 278 367 45 LABOR 6 0 55 64 723 812 991 01 80729 0 09 98 87 76 54321 5 4 3 20190897854321 79 648 537 4 3 2 1 0 9 8 7 34565 74 83 9 8254321 71 60 59 4 3 2 1 0 9 8 7 6 5 4 3 2 1 0 9 8 7 0 9 8 7 54321 0 9 8 7 54321 0 0 238 47 565 74 83 92 010 29 38 47 565 74 83 92 09 6185074954321 3 27 16 0 94 8 72 6 8765 5 3 1250349438052796168705789454321 238 45 0 79 88 97 0154321 9302112 4003992881770654321 9 84 73 6 51 4 39 2 1 06 95084973862751 40 3 2 0 8 345675 8 9 00 19 28 37 4 54321 57 67890123 2954321 18 07 96 8 7 6 5 4 3 2 1 0 9 8 7 63 52 41 3002991 0 9 8 7 54321 0 9 45675 84 93 01221304958677688579454321 012345 0889778654321 75 64 53 4 3 2 1 0 9 8 7 6 5 4 3 54321 2 19 08 9 0 9 8 7 54321 0 9 8 6 890121 30 49 58 676 85 94 03 1 271 30 456 8707696585474354321 32 21 10 0 9 8 7 6 5 4 3 2 1 0 987 0 9 8 7 54321 0 9 8 8 9 01 2 3 4 5968778695041322314059768778 6654321 5 44 33 2 11 0 99 8 7 66 5504493382271154321 0 99 88 7706695 2 0 8 95 0 1 20 39 48 57 6 54321 77 89012340 56789 4583472354321 12 01 90 8 7 6 5 4 3 2 1 0 9 8 6543 979 888 797 6054321 5142332041950869777854321 01 2 3 4 5 60 8796051 2401390289178054321 7 68 57 4 35 2 13 0 9 80 79068957846735 24 1 54321 6 4 2 2 4569 7 90 09 18 27 41 5 6 7 9 01 2 3 0354321 92 81 70 6 5 4 3 2 1 0 9 8 7 6 75854321 4 36 25 1400399 0 9 8 7 54321 0 9 45679 88 97 06 15 24 33 42 51 60 789 897 01234 8287176054321 59 48 37 2 1 0 9 8 7 6 5 4 3 2 1 04 93 82 7 0 9 8 7 54321 0 9 8 5678906 15 24 33 42 51 60 79 88 97 01672554321 3456 6105094983872754321 16 05 94 8 7 6 5 4 3 2 1 0 9 8 772 61 5 3 2 1 0 98 78 0123 0 59 68 77 8 54321 07 16 205 39483 567 4054321 39 28 17 0 9 8 7 6 5 4 3 2 1 0 9 8 7 6 543 9782673554321 6 5 47 3 2 8 0 10 29 38 5 54321 61 70 8 908 01 4453627108099 2981870754321 9 85 74 6 52 4 30 2 1 07 9608597486375254321 4 30 29 1 3 1 9 0126 3 4 50 69 78 87 9 54321 08 12345671 890 0809798687576454321 53 42 31 2 1 0 9 8 7 6 5 4 3 2 109 0 9 8 7 54321 0 9 8 1 2 3 4 5 6 7 8 9 01 2 36455463728190709182 8754321 7 65 54 4 32 2 10 0 9 87 7606595484373254321 2 10 09 9808797 54321 3 1 9 36 4 60 79 88 97 18 234 6781 9 123 6685574454321 33 22 11 0 9 8 7 6 5 4 3 2 1 0 8765 6556473082991800719954321 4 6 7 8 9 0019 28 37 454321 2837465 4503492381270154321 9 89 78 6 56 4 34 2 1 01 90089978867756 45 3 7 5 3 678900 1 2 30 49 58 67 7 54321 82 90123456 MODEL NO.
0987 54321 0987 54321 0987 54321 0987 54321 0987 54321 0987 54321 0987 54321 0987
DESCRIPTION
0 9 8 7 54321 0 9 8 7 54321 0 9 8 7 54321 0 9 8 7 54321 0 9 8 7 54321 0 9 8 9 8 70 9 7 54321 0 9 8 70 54321 9 8 7 0 9 8 7 054321 0 90 8 7 54321 0 9 54321 8 7 54321 7 54321 0 9 0 9 854321 9 8 7 54321 0 89 78 54321 7 54321 0 9887754321 54321 0987 0 9 8 7 54321 0 9 8 7 54321 00998877 0 9 8 7 54321 0 9 5432100998 54321 0 9 8 7 54321 54321 00 99 8 7 54321 8 7 54321 7 54321 7 54321 0 9 8 87 754321 09 543210 9 8 7854321 0987 87 0 8 7 54321 0 9 08 97 854321 0 9 807954321 7 54321 0 9 09 9 8 7 54321 0 54321 9 8 7 54321 8 7 54321 0 9 0 954321 8 7 54321 0 9 8 7 54321 0 9 8 7 54321 0897854321 7 8 7 54321 0987 0 9 8 70 9 8 54321 0 9 8 7 054321 9 8 7 0 9 8 7 54321 54321 0 9 7 54321 0 9 8 54321 7 54321 543210099 0 90 9 8 754321 8 7 54321 543210 8 7 54321 0 9 88 77 54321 54321 0 9 887754321 0987 7 9 8 7 54321 0 09 98 87 754321 0 90897854321 54321 0 9 0 9 8 7 54321 0 9 8 7 54321 054321 987 09 54321 0 9 8 7 54321 8 7 54321 54321 0 9 8 7 854321 0 9 8 7 54321 098 7 54321 0987 987 09 7 54321 0 9 8 07 954321 8 7 0 9 8 7054321 54321 0 9 0 90 8 7 54321 0 9 54321 8 7 54321 7 54321 0 9 0 9 854321 9 8 78 67 554321 43 2 1 90 89 78 67 5 4 3 254321 1 9 8 07 9
MANUFACTURER
BROCK TOOL
BROCK NO.
SHIPPED
FILLED BY
9 8 7 6 51 42 33 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 2 1 9 8 87 96 05 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 4 93 82 71 6 69 5 78 4 87 39 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 2 1 9 8 47 56 65 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 4 3 2 1 29 38 47 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0123456789012345678901234567 8901234567890123456789012345 6789012345678901234567890123 4567890123456789012345678901 2345678901234567890123456789 0123456789012345678901234567 8901234567890123456789012345 6789012345678901234567890123 4567890123456789012345678901 2345678901234567890123456789
QUAN.
SHOP TICKET
CUSTOMER ORDER NUMBER
NO. R-
SHIP VIA
DATE ________________________
ACCT. NO.:
DATE ________________________
DATE SHIPPED
SERVING INDUSTRY AND CONTRACT ORS
CUSTOMER _______________________________________________
1401 E. RIVERSIDE DR. INDIANAPOLIS, IN 46202 317.634.7575
CUSTOMER _______________________________________________
DATE
TOOL _____________________________________________________
NUMBER
R-
TOOL _____________________________________________________
BROCK TOOLCOMPANY