RECEIPT
East Repair Inc.
1912 Harvest Lane
New York City
BILL TO
SHIP TO
RECEIPT#
US-001
John Smith
John Smith
RECEIPT DATE
11/02/2019
2 Quart Square
37 Drive
P.O.#
2023/2019
New York, NY 1222
Cambridge, MA 16543
DUE DATE
26/2/2019
1
Front and rear break cables
$ 100.00
$ 100.00
2
New set of pedal arms
$ 15.00
$ 30.00
3
Lollipops
$ 5.00
$ 15.00
Subtotal
$ 145.00
Sales Tax 6.25%
9.06
TOTAL
$ 154.06
Thank You
Payment is due within 15 days.