HomeMy WebLinkAbout2013 w-2 and 1099 order t p
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2305 Circadian Wa voice: 866-667-2861
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Santa Rosa, Ca 95407 Fax: 707-547-4542
Date: Aug 7 2013
Bill to: City of Oak Park Heights Ship To: City of Oak Park Heights
P O BOX 2007 14168 Oak Park Blvd N
Oak Park Heights, MN 55082 Oak Park Heights MN 55082
gbrunckhorst @cityofoakparkheights.com
Attn: Gary Brunckhorst
Purchase Order#: W O 100 0 2D Acct#: 45-5842120
Form Number/ Description Qty Price Extended Price
BW24UP05 W2 4up Employee 100 18.00
4UPDWENVS05 W2 SELF SEAL envelopes 100 14.50
BW24UPER05 W2 4up Employer 100 18.00
BW2FED05 W2 Employer Fed Copy A 100 18.00
BMISFED05 1099 MISC Fed Copy A 100 9.00
BMISREC05 1099 MISC Recipient Copy B 100 9.00
BMISPAY05 1099 MISC Payer/State Copy C 100 9.00
RDWENVS05 1099 SELF SEAL envelopes 100 10.50
Payment by Credit Card Sub Total 106.00
Visa/MasterCard/American Express Estimated Shipping 19.16
Please circle
b; ,\ V's p 1.&MS e Total 124.10
Shipping charges are estimated therefore your invoice may
Credit Card Number exp reflect a slightly different amount.
3 digit code on back of card
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Autho zed buyer's signature(please print and Si>Yn) Title
If you have any questions do not hesitate to call.
Thank you for your order! PLEASE SIGN AND FAX BACK TO PLACE YOUR
ORDER
Liz Bjornstad
Account Manager
866-667-2861 Ext 6373
Fax: 707-547-4542
E-mail: lbj ornstadk r)ri nt-2-mai 1.com
2305 Circadian Way—Santa Rosa,CA 95407-0789—Toll Free:(866)667-2861 — Fax:(707)547-4542—Internet:W W W.print-2-mail.coin