Municipal Emergency Services, Inc.					Sales Order
			1751 North County Road 20th Avenue				Page	1	of
			Fremont, NE  68025
			(800) 228-9014 Toll Free					Sales Rep
			(402) 727-5785 Phone					Cust. No.
			(402) 727-5789 Facsimile					Date
Bill To:						Ship To:
Name						Name
Department						Department
Address						Address
City						City
State		ZIP				State		ZIP
Phone						Phone
	Quote		Credit		Order		PO No.
Quantity	Part Number		Description						Unit Price	Total
Ship Via		FOB Ship Point	Dest		Date			Subtotal
								Sales Tax
Notes:								Shipping
								TOTAL