Givaudan Delivery Invoice Summary
Givaudan Delivery Invoice Summary
Please tear off and send with your payment in the enclosed envelope. Do not use staples or paper clips.
Page 2 of 12
Page 3 of 12
Outbound
Vendor Manifest
Pickup Pickup ZIP Published Incentive Billed
Date Record Entry Tracking Number Service Code Zone Weight Charge Credit Charge
05/09 4530029195 1 1Z9714430330508275 Ground Commercial Third 48104 8 46 0.00 0.00
Party
Customer entered weight 32
1st ref: 4213041 2nd ref : 00307838
Sender : Receiver: KEVIN JACOBI
MUEHLIG FUNERAL HOME
403 S 4TH AVE
ANN ARBOR MI 48104
2 1Z9714430330508284 Ground Commercial Third 48104 8 7 0.00 0.00
Party
Customer entered weight 6.8
1st ref: 4213041 2nd ref : 00307838-00002
Sender : Receiver: KEVIN JACOBI
MUEHLIG FUNERAL HOME
403 S 4TH AVE
ANN ARBOR MI 48104
3 1Z9714430330508239 Ground Commercial Third 91360 2 28 0.00 0.00
Party
1st ref: 6259 2nd ref : 00307844
Sender : Receiver: RICH RIDER
CALIFORNIA LUTHERAN UN IVERSITY
60 WEST OLSEN RD 3400
THOUSAND OAKS CA 91360
4 1Z9714430330508248 Ground Commercial Third 91360 2 28 0.00 0.00
Party
1st ref: 6259 2nd ref : 00307844-00002
Sender : Receiver: RICH RIDER
CALIFORNIA LUTHERAN UN IVERSITY
60 WEST OLSEN RD 3400
THOUSAND OAKS CA 91360
5 1Z9714430330508257 Ground Commercial Third 91360 2 28 0.00 0.00
Party
1st ref: 6259 2nd ref : 00307844-00003
Sender : Receiver: RICH RIDER
CALIFORNIA LUTHERAN UN IVERSITY
60 WEST OLSEN RD 3400
THOUSAND OAKS CA 91360
6 1Z9714430330508211 Ground Commercial Third 50525 6 12 0.00 0.00
Party
Customer entered weight 11.7
1st ref: 1122003 2nd ref : 00307847
Sender : Receiver: LORITTA LARUE
WRIGHT MEDICAL CENTER
1316 S. MAIN STREET
CLARION IA 50525
7 1Z9714430330508220 Ground Commercial Third 50525 6 82 0.00 0.00
Party
Customer entered weight 21
1st ref: 1122003 2nd ref : 00307847-00002
Sender : Receiver: LORITTA LARUE
WRIGHT MEDICAL CENTER
1316 S. MAIN STREET
CLARION IA 50525
8 1Z9714430330508266 Ground Commercial Third 23459 8 8 0.00 0.00
Party
1st ref: 5100182987 2nd ref : 00307874
Sender : Receiver: NAVY GATEWAY INNS/SUIT ES
1350 GATOR BLVD
VIRGINIA BEACH VA 23459
Total for Pickup Number: 4530029195 8 Package(s) 0.00
Delivery Service Invoice
Invoice date May 14, 2011
Invoice number 0000971443201
Shipper number 971443
Page 4 of 12
Outbound
Vendor Manifest (continued)
Pickup Pickup ZIP Published Incentive Billed
Date Record Entry Tracking Number Service Code Zone Weight Charge Credit Charge
05/10 4530029206 1 1Z9714430330508346 Ground Commercial Third 08016 8 40 0.00 0.00
Party
Customer entered weight 24.9
1st ref: 00307446-00002
Sender : Receiver: HD SUPPLY 0022
1100 JOHN GALT WAY, ST E 1
BURLINGTON NJ 08016
2 1Z9714430330508355 Ground Commercial Third 08016 8 40 0.00 0.00
Party
Customer entered weight 24.9
1st ref: 00307446-00003
Sender : Receiver: HD SUPPLY 0022
1100 JOHN GALT WAY, ST E 1
BURLINGTON NJ 08016
3 1Z9714430330508364 Ground Commercial Third 08016 8 40 0.00 0.00
Party
Customer entered weight 24.9
1st ref: 00307446-00004
Sender : Receiver: HD SUPPLY 0022
1100 JOHN GALT WAY, ST E 1
BURLINGTON NJ 08016
4 1Z9714430330508373 Ground Commercial Third 08016 8 40 0.00 0.00
Party
Customer entered weight 24.9
1st ref: 00307446-00005
Sender : Receiver: HD SUPPLY 0022
1100 JOHN GALT WAY, ST E 1
BURLINGTON NJ 08016
5 1Z9714430330508337 Ground Residential Third 33410 8 68 0.00 0.00
Party
Customer entered weight 32
1st ref: 119182950794 2nd ref : 00307511
Sender : Receiver: EILEEN HIRSCH
12220 HILLMAN DR
PALM BEACH GARDENS FL 33410
6 1Z9714430330508293 Ground Commercial Third 64138 6 2 0.00 0.00
Party
Customer entered weight 1.5
1st ref: 151188250794 2nd ref : 00307900
Sender : Receiver: MATTHEW JOHNSON
HILLCREST COUNTRY CLUB
8200 HILLCREST RD.
KANSAS CITY MO 64138
7 1Z9714430330508382 Ground Commercial Third 02035 8 9 0.00 0.00
Party
1st ref: P12174 2nd ref : 00307928
Sender : Receiver: STEVE PASCALE
NORMANDY FARMS CAMPGRO UND
72 WEST ST
FOXBORO MA 02035
8 1Z9714430330508328 Ground Commercial Third 10028 8 90 0.00 0.00
Party
Customer entered weight 54
1st ref: 109659 2nd ref : 00307933
Sender : Receiver: CINDIE KASTENBAUM
25 EAST END AVE
NEW YORK NY 10028
Delivery Service Invoice
Invoice date May 14, 2011
Invoice number 0000971443201
Shipper number 971443
Page 5 of 12
Outbound
Vendor Manifest (continued)
Pickup Pickup ZIP Published Incentive Billed
Date Record Entry Tracking Number Service Code Zone Weight Charge Credit Charge
05/10 4530029206 9 1Z9714430330508319 Ground Residential Third 07039 8 75 0.00 0.00
Party
Customer entered weight 28.2
1st ref: 109657 2nd ref : 00307935
Sender : Receiver: SANDRA MARKMAN
71 ROCKLEDGE DR
LIVINGSTON NJ 07039
10 1Z9714430330508300 Ground Commercial Third 48309 8 46 0.00 0.00
Party
Customer entered weight 32
1st ref: 4214693 2nd ref : 00307939
Sender : Receiver: MARK JUREK
RED ROOF INN # 10191
2580 CROOKS RD
ROCHESTER HILLS MI 48309
11 1Z9714430330508391 Ground Commercial Third 60611 7 90 0.00 0.00
Party
Customer entered weight 61.7
1st ref: 4214865 2nd ref : 00307954
Sender : Receiver: JOE
OMNIBUS REAL ESTATE
209 E LAKE SHORE DR
CHICAGO IL 60611
Total for Pickup Number: 4530029206 11 Package(s) 0.00
05/11 4530029210 1 1Z9714430330508435 Ground Commercial Third 60134 7 27 0.00 0.00
Party
Customer entered weight 19
1st ref: 4187512 2nd ref : 00306279
Sender : Receiver: CHRISTINE REINSDORFF
DELNOR COMMUNITY HOSPI TAL
300 RANDALL RD
GENEVA IL 60134
2 1Z9714430330508444 Ground Commercial Third 60134 7 27 0.00 0.00
Party
Customer entered weight 19
1st ref: 4187512 2nd ref : 00306279-00002
Sender : Receiver: CHRISTINE REINSDORFF
DELNOR COMMUNITY HOSPI TAL
300 RANDALL RD
GENEVA IL 60134
3 1Z9714430330508453 Ground Commercial Third 60134 7 27 0.00 0.00
Party
Customer entered weight 19
1st ref: 4187512 2nd ref : 00306279-00003
Sender : Receiver: CHRISTINE REINSDORFF
DELNOR COMMUNITY HOSPI TAL
300 RANDALL RD
GENEVA IL 60134
4 1Z9714430330508515 Ground Commercial Third 11101 8 68 0.00 0.00
Party
Customer entered weight 32
1st ref: 119188980794 2nd ref : 00307638
Sender : Receiver: PABLO ROSARIO
RAVEL MOTEL
808 QUEENS PLZ. S.
LONG ISLAND CITY NY 11101
Delivery Service Invoice
Invoice date May 14, 2011
Invoice number 0000971443201
Shipper number 971443
Page 6 of 12
Outbound
Vendor Manifest (continued)
Pickup Pickup ZIP Published Incentive Billed
Date Record Entry Tracking Number Service Code Zone Weight Charge Credit Charge
05/11 4530029210 5 1Z9714430330508462 Ground Commercial Third 58254 7 68 0.00 0.00
Party
Customer entered weight 32
1st ref: 13373960794 2nd ref : 00307750
Sender : Receiver: STEVE FORDE
MCVILLE ASSISTED LIVIN G
514 N. OLSGARD
MCVILLE ND 58254
6 1Z9714430330508471 Ground Commercial Third 58254 7 7 0.00 0.00
Party
Customer entered weight 6.8
1st ref: 13373960794 2nd ref : 00307750-00002
Sender : Receiver: STEVE FORDE
MCVILLE ASSISTED LIVIN G
514 N. OLSGARD
MCVILLE ND 58254
8 1Z9714430330508597 Ground Commercial Third 55106 7 66 0.00 0.00
Party
Customer entered weight 35.4
1st ref: CAS00000098 2nd ref : 00307859
Sender : Receiver: HEALTH SYSTEMS CORP.
725 MINNEHAHA AVE
ST PAUL MN 55106
9 1Z9714430330508604 Ground Commercial Third 55106 7 66 0.00 0.00
Party
Customer entered weight 35.4
1st ref: CAS00000098 2nd ref : 00307859-00002
Sender : Receiver: HEALTH SYSTEMS CORP.
725 MINNEHAHA AVE
ST PAUL MN 55106
10 1Z9714430330508613 Ground Commercial Third 75088 6 80 0.00 0.00
Party
1st ref: 124884-1 2nd ref : 00308011
Sender : Receiver: PO# 0038101449
LAKE POINTE MED CTR
6800 SCENIC DR
ROWLETT TX 75088
11 1Z9714430330508622 Ground Commercial Third 75088 6 14 0.00 0.00
Party
1st ref: 124884-1 2nd ref : 00308011-00002
Sender : Receiver: PO# 0038101449
LAKE POINTE MED CTR
6800 SCENIC DR
ROWLETT TX 75088
12 1Z9714430330508480 Ground Commercial Third 46556 7 68 0.00 0.00
Party
Customer entered weight 32
1st ref: 0002474 2nd ref : 00308012
Sender : Receiver: LYNN HOLBROOK
UNIVERSITY OF NOTRE DA ME
021 DEBARTOLO CENTER
NOTRE DAME IN 46556
13 1Z9714430330508499 Ground Commercial Third 46556 7 90 0.00 0.00
Party
Customer entered weight 62.5
1st ref: 0002474 2nd ref : 00308012-00002
Sender : Receiver: LYNN HOLBROOK
UNIVERSITY OF NOTRE DA ME
021 DEBARTOLO CENTER
NOTRE DAME IN 46556
Delivery Service Invoice
Invoice date May 14, 2011
Invoice number 0000971443201
Shipper number 971443
Page 7 of 12
Outbound
Vendor Manifest (continued)
Pickup Pickup ZIP Published Incentive Billed
Date Record Entry Tracking Number Service Code Zone Weight Charge Credit Charge
05/11 4530029210 14 1Z9714430330508506 Ground Commercial Third 46556 7 14 0.00 0.00
Party
Customer entered weight 13.6
1st ref: 0002474 2nd ref : 00308012-00003
Sender : Receiver: LYNN HOLBROOK
UNIVERSITY OF NOTRE DA ME
021 DEBARTOLO CENTER
NOTRE DAME IN 46556
15 1Z9714430330508542 Ground Residential Third 26753 8 68 0.00 0.00
Party
Customer entered weight 31
1st ref: 6266 2nd ref : 00308016
Sender : Receiver: DIANE BALDWIN
OLD FURNACE RD
RIDGELY WV 26753
16 1Z9714430330508524 Ground Residential Third 72727 6 68 0.00 0.00
Party
Customer entered weight 32
1st ref: 6267 2nd ref : 00308017
Sender : Receiver: MICHAEL CLARK
15513 GOSHEN TUTTLE RD
ELKINS AR 72727
17 1Z9714430330508533 Ground Residential Third 72727 6 7 0.00 0.00
Party
Customer entered weight 6.8
1st ref: 6267 2nd ref : 00308017-00002
Sender : Receiver: MICHAEL CLARK
15513 GOSHEN TUTTLE RD
ELKINS AR 72727
18 1Z9714430330508579 Ground Commercial Third 31088 8 90 0.00 0.00
Party
Customer entered weight 54
1st ref: P12181 2nd ref : 00308020
Sender : Receiver: PATRICIA LEE
ONE HOUR
2290 MOODY RD # 100
WARNER ROBINS GA 31088
19 1Z9714430330508588 Ground Commercial Third 31088 8 13 0.00 0.00
Party
1st ref: P12181 2nd ref : 00308020-00002
Sender : Receiver: PATRICIA LEE
ONE HOUR
2290 MOODY RD # 100
WARNER ROBINS GA 31088
20 1Z9714430330508408 Ground Residential Third 73089 6 90 0.00 0.00
Party
Customer entered weight 62.5
1st ref: 6273 2nd ref : 00308041
Sender : Receiver: JERRY CAMPBELL
1486 COUNTY ST 2910
TUTTLE OK 73089
21 1Z9714430330508551 Ground Commercial Third 27536 8 68 0.00 0.00
Party
Customer entered weight 31
1st ref: 119214900794 2nd ref : 00308043
Sender : Receiver: MILAN PATEL
MILKAM HOSPITALITY
1727 NORTH GARNETT ST
HENDERSON NC 27536
Delivery Service Invoice
Invoice date May 14, 2011
Invoice number 0000971443201
Shipper number 971443
Page 8 of 12
Outbound
Vendor Manifest (continued)
Pickup Pickup ZIP Published Incentive Billed
Date Record Entry Tracking Number Service Code Zone Weight Charge Credit Charge
05/11 4530029210 22 1Z9714430330508560 Ground Commercial Third 27536 8 7 0.00 0.00
Party
Customer entered weight 6.4
1st ref: 119214900794 2nd ref : 00308043-00002
Sender : Receiver: MILAN PATEL
MILKAM HOSPITALITY
1727 NORTH GARNETT ST
HENDERSON NC 27536
23 1Z9714430330508426 Ground Commercial Third 38478 7 30 0.00 0.00
Party
Customer entered weight 19
1st ref: PO129177 2nd ref : 00308048
Sender : Receiver: CUST PO# 35455
HILLSIDE HOSPITAL
1265 E. COLLEGE ST.
PULASKI TN 38478
Total for Pickup Number: 4530029210 22 Package(s) 0.00
05/12 4530029221 1 1Z9714430330508800 Ground Commercial Third 83301 5 90 0.00 0.00
Party
Customer entered weight 52
1st ref: AEL5988540 2nd ref : 00307958
Sender : Receiver: MOTEL 6 TWIN FALLS
1472 BLUE LAKES BLVD. N.
TWIN FALLS ID 83301
2 1Z9714430330508784 Ground Commercial Third 53158 7 20 0.00 0.00
Party
Customer entered weight 19.4
1st ref: 459642 2nd ref : 00307972
Sender : Receiver: UNITED HEALTH SYSTEM I NC SCMC
[Link] MEDICAL [Link]
PLEASANT PRAIRIE WI 53158
3 1Z9714430330508631 Ground Commercial Third 42519 8 56 0.00 0.00
Party
Customer entered weight 34
1st ref: 4216377 2nd ref : 00308049
Sender : Receiver: ALICE JACKSON
SEVEN GABLES MOTEL
8064 S HWY 27
BURNSIDE KY 42519
4 1Z9714430330508766 Ground Residential Third 54751 7 82 0.00 0.00
Party
Customer entered weight 37
1st ref: 119221310794 2nd ref : 00308103
Sender : Receiver: ROBERTA SHERVEY
707 RIVER HEIGHTS RD
MENOMONIE WI 54751
5 1Z9714430330508720 Ground Residential Third 47421 7 68 0.00 0.00
Party
Customer entered weight 32
1st ref: 119080360794 2nd ref : 00308105
Sender : Receiver: DONALD FAIR
326 THE WOODS
BEDFORD IN 47421
Delivery Service Invoice
Invoice date May 14, 2011
Invoice number 0000971443201
Shipper number 971443
Page 9 of 12
Outbound
Vendor Manifest (continued)
Pickup Pickup ZIP Published Incentive Billed
Date Record Entry Tracking Number Service Code Zone Weight Charge Credit Charge
05/12 4530029221 6 1Z9714430330508739 Ground Residential Third 47421 7 7 0.00 0.00
Party
Customer entered weight 6.8
1st ref: 119080360794 2nd ref : 00308105-00002
Sender : Receiver: DONALD FAIR
326 THE WOODS
BEDFORD IN 47421
7 1Z9714430330508702 Ground Commercial Third 07740 8 68 0.00 0.00
Party
Customer entered weight 32
1st ref: 119214280794 2nd ref : 00308106
Sender : Receiver: JIM MALONEY
SUDS BY THE SHORE
425 LIBERTY STREET
LONG BRANCH NJ 07740
8 1Z9714430330508711 Ground Commercial Third 07740 8 90 0.00 0.00
Party
Customer entered weight 62
1st ref: 119214280794 2nd ref : 00308106-00002
Sender : Receiver: JIM MALONEY
SUDS BY THE SHORE
425 LIBERTY STREET
LONG BRANCH NJ 07740
9 1Z9714430330508659 Ground Commercial Third 35007 7 50 0.00 0.00
Party
1st ref: PO129521 2nd ref : 00308110
Sender : Receiver: CUST. PO.# 7793
SHELBY AMBULATORY SURG ERY CTR.
1010 1ST. N. BOX 400
ALABASTER AL 35007
10 1Z9714430330508668 Ground Commercial Third 35007 7 14 0.00 0.00
Party
1st ref: PO129521 2nd ref : 00308110-00002
Sender : Receiver: CUST. PO.# 7793
SHELBY AMBULATORY SURG ERY CTR.
1010 1ST. N. BOX 400
ALABASTER AL 35007
11 1Z9714430330508677 Ground Commercial Third 35007 7 11 0.00 0.00
Party
1st ref: PO129521 2nd ref : 00308110-00003
Sender : Receiver: CUST. PO.# 7793
SHELBY AMBULATORY SURG ERY CTR.
1010 1ST. N. BOX 400
ALABASTER AL 35007
12 1Z9714430330508757 Ground Commercial Third 81301 4 56 0.00 0.00
Party
Customer entered weight 37
1st ref: 4217756 2nd ref : 00308114
Sender : Receiver: JUDITH MILLER
DURANGO LODGE
150 E 5TH ST
DURANGO CO 81301
13 1Z9714430330508640 Ground Commercial 14625 8 90 0.00 0.00
Collect
Customer entered weight 62.5
1st ref: 1726 2nd ref : 00308127
Sender : Receiver: EMPIRE LAUNDRY MACHINE RY INC
860 LINDEN AVE
ROCHESTER NY 14625
Delivery Service Invoice
Invoice date May 14, 2011
Invoice number 0000971443201
Shipper number 971443
Page 10 of 12
Outbound
Vendor Manifest (continued)
Pickup Pickup ZIP Published Incentive Billed
Date Record Entry Tracking Number Service Code Zone Weight Charge Credit Charge
05/12 4530029221 14 1Z9714430330508686 Ground Commercial 07936 8 67 0.00 0.00
Collect
Customer entered weight 21
1st ref: 11285 2nd ref : 00308133
Sender : Receiver: IRENE
GIVAUDAN
717 RIDGEDALE AVE.
EAST HANOVER NJ 07936
15 1Z9714430330508695 Ground Commercial 07936 8 82 0.00 0.00
Collect
Customer entered weight 21
1st ref: 11285 2nd ref : 00308133-00002
Sender : Receiver: IRENE
GIVAUDAN
717 RIDGEDALE AVE.
EAST HANOVER NJ 07936
16 1Z9714430330508748 Ground Residential Third 23188 8 90 0.00 0.00
Party
Customer entered weight 44.2
1st ref: CHUCK51111 2nd ref : 00308144
Sender : Receiver: JANET PARK
101 MILES MAHONE LN
WILLIAMSBURG VA 23188
17 1Z9714430330508775 Ground Commercial Third 32063 8 82 0.00 0.00
Party
Customer entered weight 37
1st ref: 6274 2nd ref : 00308151
Sender : Receiver: LYN TAYLOR
BAKER COUNTY SHERIFF OFFICE
1 SHERIFF OFFICE DR
MACCLENNY FL 32063
Total for Pickup Number: 4530029221 17 Package(s) 0.00
05/13 4530029232 1 1Z9714430330508864 Ground Commercial Third 87507 5 6 0.00 0.00
Party
Customer entered weight 5.1
1st ref: 151194640794 2nd ref : 00308071
Sender : Receiver: MARK HAWRYLAK
JOE'S DINER & PIZZA
2801 RODEO RD. STE. A5
SANTA FE NM 87507
2 1Z9714430330508882 Ground Commercial Third 94558 4 56 0.00 0.00
Party
Customer entered weight 37
1st ref: 4218836 2nd ref : 00308182
Sender : Receiver: GRAHAM
LA RESIDENCE COUNTRY I NN
4066 HOWARD LN
NAPA CA 94558
3 1Z9714430330508828 Ground Commercial Third 19464 8 64 0.00 0.00
Party
1st ref: PO129879 2nd ref : 00308183
Sender : Receiver: [Link].#31786
POTTSTOWN MEMORIAL MED .CTR.
1600 E. HIGH ST.
POTTSTOWN PA 19464
Delivery Service Invoice
Invoice date May 14, 2011
Invoice number 0000971443201
Shipper number 971443
Page 11 of 12
Outbound
Vendor Manifest (continued)
Pickup Pickup ZIP Published Incentive Billed
Date Record Entry Tracking Number Service Code Zone Weight Charge Credit Charge
05/13 4530029232 4 1Z9714430330508837 Ground Commercial Third 19464 8 14 0.00 0.00
Party
1st ref: PO129879 2nd ref : 00308183-00002
Sender : Receiver: [Link].#31786
POTTSTOWN MEMORIAL MED .CTR.
1600 E. HIGH ST.
POTTSTOWN PA 19464
5 1Z9714430330508846 Ground Commercial Third 19464 8 11 0.00 0.00
Party
1st ref: PO129879 2nd ref : 00308183-00003
Sender : Receiver: [Link].#31786
POTTSTOWN MEMORIAL MED .CTR.
1600 E. HIGH ST.
POTTSTOWN PA 19464
6 1Z9714430330508855 Ground Commercial Third 19464 8 4 0.00 0.00
Party
Customer entered weight 3.3
1st ref: PO129879 2nd ref : 00308183-00004
Sender : Receiver: [Link].#31786
POTTSTOWN MEMORIAL MED .CTR.
1600 E. HIGH ST.
POTTSTOWN PA 19464
7 1Z9714430330508908 Ground Residential Third 07305 8 82 0.00 0.00
Party
Customer entered weight 37
1st ref: 109702 2nd ref : 00308184
Sender : Receiver: TERRY HALL
42 LOCUST ST
JERSEY CITY NJ 07305
8 1Z9714430330508917 Ground Residential Third 07305 8 8 0.00 0.00
Party
1st ref: 109702 2nd ref : 00308184-00002
Sender : Receiver: TERRY HALL
42 LOCUST ST
JERSEY CITY NJ 07305
9 1Z9714430330508935 Ground Commercial Third 04605 8 62 0.00 0.00
Party
Customer entered weight 18.3
1st ref: P12211 2nd ref : 00308186
Sender : Receiver: ELIZABETH HUDSON
DANDY DIAPER SERVICE
71 STONEHAM WAY
TRENTON ME 04605
10 1Z9714430330508873 Ground Residential Third 40351 8 90 0.00 0.00
Party
Customer entered weight 62.5
1st ref: 6280 2nd ref : 00308188
Sender : Receiver: CHRISTINE TACKETT
201 PLAYFORTH DR
MOREHAED KY 40351
11 1Z9714430330508891 Ground Commercial Third 11375 8 56 0.00 0.00
Party
Customer entered weight 37
1st ref: 4219094 2nd ref : 00308197
Sender : Receiver: CHRISTINA ROSARIO
NEW YORK SPORTS CLUB # 0132
6947 AUSTIN ST
FOREST HILLS NY 11375
Delivery Service Invoice
Invoice date May 14, 2011
Invoice number 0000971443201
Shipper number 971443
Page 12 of 12
Outbound
Vendor Manifest (continued)
Pickup Pickup ZIP Published Incentive Billed
Date Record Entry Tracking Number Service Code Zone Weight Charge Credit Charge
05/13 4530029232 12 1Z9714430330508819 Ground Residential Third 99109 5 7 0.00 0.00
Party
Customer entered weight 6.8
1st ref: 6285 2nd ref : 00308199
Sender : Receiver: NORMAN KELLAN
569 EAGLE DR
CHEWELAH WA 99109
13 1Z9714430330508926 Ground Residential Third 20124 8 68 0.00 0.00
Party
Customer entered weight 31
1st ref: 119226460794 2nd ref : 00308200
Sender : Receiver: PAULA KEATING
7242 ARCHLAW DR
CLIFTON VA 20124
14 1Z9714430330508944 Ground Commercial Third 21093 8 4 0.00 0.00
Party
Customer entered weight 3.9
1st ref: 119228080794 2nd ref : 00308204
Sender : Receiver: ARMAND SHANK
ROCCHI CONSTRUCTION CO
57 W TIMONIUM RD # 115
LUTHERVILLE TIMONIUM MD 21093
Total for Pickup Number: 4530029232 14 Package(s) 0.00
Total Vendor Manifest 72 Package(s) 0.00
Chargeback
Pickup Pickup ZIP Published Incentive Billed
Date Record Entry Tracking Number Service Code Zone Weight Charge Credit Charge
05/11 4530029210 7 1Z9714430330508417 Ground Commercial 47905 7 13 12.16 -3.16 9.00
Chargeback Surcharge 11.00 11.00
Fuel Surcharge 1.03 -0.27 0.76
Total 24.19 -3.43 20.76
Reason : Bill to Account Number Refused Charges
Original Bill To Account : 0000444150
1st ref: PO222311 2nd ref : 00307793
Sender : R & B WIRE PROD INC-12345 Receiver: CREASY SPRINGS HEALTH CAMPUS
3100 S FAIRVIEW 1750 S. CREASY LANE
SANTA ANA CA 92704 6507 LAFAYETTE IN 47905
Third Party: HP PRODUCTS
PO BOX 68310
INDIANAPOLIS IN 46268
Total Chargeback 1 Package(s) 24.19 -3.43 20.76
Total Outbound 73 Package(s) 24.19 -3.43 20.76









