Kelly Machine Order


An order has been submitted for you by your representative [esiggravity formid="24" field_id="10" display="value" ] for the customer [esiggravity formid="24" field_id="124" display="value" ]. The order is below. If the order is correct please electronically sign this document.

Your Order

Date Ordered: [esiggravity formid="24" field_id="2" display="value" ]

Requested Dispatch Date: [esiggravity formid="24" field_id="4" display="value" ]

Purchase Order Number: [esiggravity formid="24" field_id="5" display="value" ]

Dealer Salesperson: [esiggravity formid="24" field_id="6" display="value" ]

Dealer Contact Number: [esiggravity formid="24" field_id="8" display="value" ]

Is this machine to be delivered directly to the dealership?: [esiggravity formid="24" field_id="64" display="value" ]

shipping Address: [esiggravity formid="24" field_id="12" display="value" ]

Customer Details:

Customer Name:[esiggravity formid="24" field_id="124" display="value" ]

Customer Email:[esiggravity formid="24" field_id="125" display="value" ]

Customer Address:

[esiggravity formid="24" field_id="126" display="value" ]

Instructions:

[esiggravity formid="24" field_id="101" display="value" ]

Total:[esiggravity formid="24" field_id="96" display="value" ]

  Item Price
Product [esiggravity formid="24" field_id="24" display="value" ] [esiggravity formid="24" field_id="26" display="value" ]
Tyre Option [esiggravity formid="24" field_id="77" display="value" ]  
Dual Wheel Option [esiggravity formid="24" field_id="50" display="value" ][esiggravity formid="24" field_id="76" display="value" ] [esiggravity formid="52" field_id="77" display="value" ][esiggravity formid="24" field_id="116" display="value" ][esiggravity formid="24" field_id="194" display="value" ][esiggravity formid="24" field_id="195" display="value" ]
Front Chain Selection [esiggravity formid="24" field_id="42" display="value" ][esiggravity formid="24" field_id="71" display="value" ][esiggravity formid="24" field_id="72" display="value" ][esiggravity formid="24" field_id="73" display="value" ][esiggravity formid="24" field_id="132" display="value" ][esiggravity formid="24" field_id="74" display="value" ] [esiggravity formid="24" field_id="40" display="value" ][esiggravity formid="24" field_id="103" display="value" ][esiggravity formid="24" field_id="104" display="value" ][esiggravity formid="24" field_id="105" display="value" ][esiggravity formid="24" field_id="133" display="value" ][esiggravity formid="24" field_id="106" display="value" ]
Rear Chain Selection [esiggravity formid="24" field_id="42" display="value" ][esiggravity formid="24" field_id="71" display="value" ][esiggravity formid="24" field_id="72" display="value" ][esiggravity formid="24" field_id="73" display="value" ][esiggravity formid="24" field_id="134" display="value" ][esiggravity formid="24" field_id="74" display="value" ] [esiggravity formid="24" field_id="44" display="value" ][esiggravity formid="24" field_id="107" display="value" ][esiggravity formid="24" field_id="108" display="value"][esiggravity formid="24" field_id="109" display="value" ][esiggravity formid="24" field_id="135" display="value" ][esiggravity formid="24" field_id="110" display="value" ]
Supplemental Chain Option (front) [esiggravity formid="24" field_id="149" display="value" ][esiggravity formid="24" field_id="167" display="value" ] [esiggravity formid="24" field_id="151" display="value" ][esiggravity formid="24" field_id="157" display="value" ][esiggravity formid="24" field_id="158" display="value" ][esiggravity formid="24" field_id="159" display="value" ][esiggravity formid="24" field_id="160" display="value" ][esiggravity formid="24" field_id="161" display="value" ]
Supplemental Chain Option (rear) [esiggravity formid="24" field_id="150" display="value" ][esiggravity formid="24" field_id="168" display="value" ][esiggravity formid="24" field_id="169" display="value" ][esiggravity formid="24" field_id="170" display="value" ] [esiggravity formid="24" field_id="156" display="value" ][esiggravity formid="24" field_id="162" display="value" ][esiggravity formid="24" field_id="163" display="value" ][esiggravity formid="24" field_id="164" display="value" ][esiggravity formid="24" field_id="165" display="value" ][esiggravity formid="24" field_id="166" display="value" ]
Hitch Option [esiggravity formid="24" field_id="138" display="value" ][esiggravity formid="24" field_id="139" display="value" ][esiggravity formid="24" field_id="140" display="value" ]  
Cover Crop Seeding Option [esiggravity formid="24" field_id="141" display="value" ] [esiggravity formid="24" field_id="116" display="value" ]
Additional Products [esiggravity formid="24" field_id="180.1" display="value" ] [esiggravity formid="24" field_id="188.1" display="value" ] [esiggravity formid="24" field_id="189.1" display="value" ] [esiggravity formid="24" field_id="182.1" display="value" ] [esiggravity formid="24" field_id="183.1" display="value" ] [esiggravity formid="24" field_id="184.1" display="value" ] [esiggravity formid="24" field_id="186" display="value" ] [esiggravity formid="24" field_id="187" display="value" ] [esiggravity formid="24" field_id="190" display="value" ] [esiggravity formid="24" field_id="191" display="value" ] [esiggravity formid="24" field_id="192" display="value" ] [esiggravity formid="24" field_id="193" display="value" ] [esiggravity formid="24" field_id="208" display="value" ] [esiggravity formid="24" field_id="209" display="value" ] [esiggravity formid="24" field_id="210" display="value" ] [esiggravity formid="24" field_id="211" display="value" ] [esiggravity formid="24" field_id="212" display="value" ] [esiggravity formid="24" field_id="213" display="value" ] [esiggravity formid="24" field_id="214" display="value" ] [esiggravity formid="24" field_id="215" display="value" ] [esiggravity formid="24" field_id="216" display="value" ] [esiggravity formid="24" field_id="217" display="value" ]
Sub Total: [esiggravity formid="24" field_id="54" display="value" ]
30 Day Discount Percent: [esiggravity formid="24" field_id="113" display="value" ]
15 Day Discount Percent: [esiggravity formid="24" field_id="174" display="value" ]
Discount: [esiggravity formid="24" field_id="206" display="value" ] [esiggravity formid="24" field_id="205" display="value" ] [esiggravity formid="24" field_id="203" display="label_value" ]
Total: [esiggravity formid="24" field_id="96" display="value" ]
Surcharge: [esiggravity formid="24" field_id="200" display="value" ]
Total price including Surcharges: [esiggravity formid="24" field_id="201" display="value" ]

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Kelly Engineering https://usa.kellytillage.com
Signature Certificate
Document name: Kelly Machine Order
lock iconUnique Document ID: 84d8f1d27d674e60b89ffa03d20db51886bbf7e3
Timestamp Audit
August 6, 2018 3:16 am EDTKelly Machine Order Uploaded by Kelly Sales - sales@usa.kellytillage.com IP 150.101.23.241