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Heinz North America Division of H.J.Heinz Company,LP. / :equisition No.-Date Approp./SI No.-Date SCOA No. Date of Order "5 / TYPE OF REQUEST SHIP TO: ❑ REQUEST FOR SHIPMENT ❑ REQUEST TO SELL OR SCRAP TYPE OF SHIPMENT ❑ SALE TO VENDOR* ❑ SALE TO EMPLOYEE* BILL TO: ❑ RETURN FOR REPAIR ❑ PURCHASE REJECTION ❑ PURCHASE RETURN RETURN REPAIRED EQUIPMENT TO: ❑ DONATION-NOT FINISHED GOODS* ❑ TRADE-IN arms Roul:5,.Via ( F.O.B. Ship to Arrive fl�q QUANTITY UNIT ITEM DESCRIPTION PRICE/UNIT EXTENSION * �1~ Zr.i SHIPPING POINT "viUST SHG.tiFOR SHIPPING CHARGE... OF JPREPAID SHIPPING CHARGES IN ALL iNS T A NCE - ,,i/:L-'FRE RECIP!ENT IS RESPONSiBL E. ..cC!PIEIVT ❑ H. J. nElidZ CO. E;i�lZ M^.I ES NO 1NARRANTY, REPRESENTATION OR GIiARANTEE EXPRESS OR IMPLIED, 1ESPECTING THE ABOVE DECr,iBED PROPERTY, WHETHER RELATED T.0 _ CONDI T ION, MERCHANTA.- iLiTY, GR FITNESS FOR ANY PARTICULAR PURPOSE. RECIPIENT SPECIFIC.". S THE ABOVE DESCRIBED �iJPEP,TY "AS 15" Al'JC 'VtiHERE IS" AND SHALL BE CONCLUSIVELY PRESi ,IED TO HAVE KNOWLEDGE OF ITS AGF, :OINDITION, PRIOR USE AND PRESENT CONDITION. '4 NO EVENT (INCLUDING ALLEGED NEGLIGENCE), SHALL --ICINZ BE ='CR ANY D,,' AGES, 11 CLUDING BCT - JOT LIMITED TO DIRECT, SPECIAL; INCIDENT-,L, PEN40 OR CON5FQ:E -7f51i:G OUT OF OR iN C&NNECTION :fI T H THE USE, CONDITION OR PERFORMAi ^"' - :LTE TOTAL hipping Location Shipment No. Gross Weight J Date Shipped ,ate Prepared Request Nn. DeliVE /Terms / Qty. Shipped ! {N`Stjecked By ovation of iten,to be Shippe Authority or 2-B Reqn. No. Car or Truck No. Carrier -- /-i i A Line Mane e' n Date Manager Date Purchasing Date P Division Hea' ,000-24,999) Date Shipper Date Account Receivable Date R V President, H.N.A. (25,000-49,999) Date Credit Terms By` ate Billing'No. J.E.V. jBy A L Corporate (50,000 and Up) Date Expected Return Date Date Returned Received By aS