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<br /> <br /> <br /> <br />Customer Acceptance: <br />Quotation Number: NC87779 Purchase Order:___________________________________ <br /> <br /> <br />Authorized Signature: <br /> <br />Print:_______________________________ Sign:_____________________________________________________________ <br /> <br />Date:_______________________________ Email:____________________________________________________________ <br /> <br />Addresses: <br /> <br />Delivery Address:________________________________________________________________________________________ <br /> <br />Billing Address (if different from ship to):_____________________________________________________________________ <br /> <br /> <br />Tax Exempt: Y ▢ / N ▢ <br /> <br />Exempt in the State of:______________________________________ <br /> <br />Tax Exempt ID: <br /> <br />Federal:__________________________________________________ <br /> <br />State:____________________________________________________ <br /> <br />Expiration Date:___________________________________________ <br />