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r�rr <br />"'I11 KK I�0 <br />N. <br />PROJEC"T C'­1A <br />GE ORDER <br />FORM <br />Customer Name <br />CITY OF SOUTH BEND <br />Solution ID <br />6123570 <br />�._ <br />6123570 <br />CITY SOUTHBEND <br />�.... <br />612mm <br />3 570 <br />WEST ERSON <br />CITY OF SOUTH BEND <br />BLVD <br />227 WEST JEFFERSON BLVD <br />SOUTH <br />SOUTH BEND IN <br />Ship -to <br />SOUTH BEND IN <br />46601 <br />6601 <br />4 <br />us <br />US <br />Phone <br />574 245-6201 <br />Customer Contact <br />Dan O'Connor <br />Email _,.n.......� <br />DOCONNOR SOUTHBENDIN GOV <br />... @ , <br />Customer <br />Payment Terms <br />Net 30 Days <br />Purchase <br />N/A <br />Order <br />Kronos Practice <br />Public Sector 20127 <br />Sales Person <br />Jessica DeWitt <br />Operating <br />Project # <br />29776 <br />Unit / <br />KRONOS US OU / USD <br />Currency <br />New Task Required <br />Yes <br />New Order <br />No <br />Required <br />Project Budget Impact <br />Project Manager 19990003-ONL I HR II Estimate <br />Solution Consultant � 9990003-ONL I HR I Estimate <br />Authorization Signatures <br />48 150.00 7,200.00 <br />128 150.00 19,200.00 <br />Totals 176.00 26,400.00 <br />Amounts exclude tax <br />(I authorize the change to the Kronos Project Buda) - ° bove, and I authorize Kronos to invoice for the amount applicable.) <br />Customer Project Manager 'm <br />in <br />, <br />Comments <br />Add project budget to account for <br />Order Management Inte is i . ,7, � )T7y <br />