ADVANCED MEDICAL SCIENCE &                 TECHNOLOGY, LLC 410 Buedel Court Sparks, MD 21152 Phone: 410-472-9209 Fax: 410-472-9219 Email: info@advancedmedicals.com Website: www.advancedmedicals.com Purchase Order Bill To: Type address here or use Mail Merge (under Tools) to automatically address this publication to multiple recipients. Purchase Order #: Date: Vendor ID:     Quantity              Item            Units Description      Unit Price            Total                                                             Subtotal   Tax   Shipping   Insurance   Balance Due   PROFORMA CONDITIONS: Orders are not finally packaged until payment is made. Therefore the Proforma Commercial Invoice is a estimated document for the purpose of prepayment and/or freight costs estimations . Actual package configurations and weights may change at final packaging.

Ship To:

Req. By	Ship When	Ship Via	FOB	Buyer	Terms	Tax ID