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Mission Uniform Service <br />7520 Reese Rd <br />Sacramento, CA 95828-3707 <br />Invoice #:508463911 <br />Page: <br />Customer #: <br />5 of 5 <br />261704 <br />10/19/2018Date: <br />Purchase Order #: <br />Payment is Due:November 10th <br />Delivery Plant: <br />Delivery Days: <br />4801 I <br />....F.. <br />Delivery Stop:Rt 22 - 90 <br />BELKORP AGRICULTURE-STOCKTON <br />1120 W Charter Way <br />Stockton, CA 952061107 <br />Deliver To <br />Customer Invoice <br />PH 916-423-3179 <br />Remit To: <br />Shortage <br />Line Emp Item Identity Invty Qty Amount Adj <br />Qty <br />Adj Amount <br />113 624 Sh-Crw-Jd-Ch/Gry-Ls JAY 6 1.98 -1.98 <br />Subtotal $497.20 Adj <br />Subtotal -23.70 <br />Sales Tax $0.00 *Adj Tax <br />Prebill Total $497.20 Adj Total -23.70 <br />Adjust Amount ($23.70) <br />Amount Due $473.50 <br />Remarks: <br />NA #5302IJB $1.00 EMB 534B $1.00 PREP $2.00 <br />Received 10/19/2018 9:18:50 AM: <br />Signed: