Invoice No.:
                                                                                                                  Invoice Date:
                                                                                                             INVOICE
                        Customer                                                                                    Remit To:
                  Name
                  Address          WESTERN KENTUCKY UNVIERSITY
                                   1906 COLLEGE HEIGHTS BLVD
                                   BOWLING GREEN KY  42101
                                 PURCHASE              ACCOUNT                  INVOICE
                                   ORDER                NUMBER                 DUE DATE                PAYMENT TERMS
                                  NUMBER
                                                                                      
                   ITEM #                                                  Description                                                 TOTAL
                                                                                                 Subtotal                                   $0.00
                                                                                                 Additional Charges
                                                                                                 TOTAL DUE                                  $0.00
               Vendor's Certification
               I hereby certify that the commodities specified above have been furnished to Western Kentucky University, that the quality and
               prices conform to the proposal and purchase order or contract; and that payment, in whole or part, has not been received.
               Signed_______________________________________________By_________________________________Date______________
               Instructions Vendor:
               1. Render invoice immediately upon completing shipment of all items per agreement. Partial payments are authorized on some
                   orders. Discount period will be computed from date of delivery or date of invoice, whichever is later.
               2. Use a separate invoice for each purchase order or completed order or contract.                  MAIL ALL INVOICES AND
               3. Be certain to insert the purchase order number or contract number.                              CORRESPONDENCE TO:
               4. Vendor's Certification must be signed on all copies.                                          PURCHASING DEPARTMENT
                                                                                                             WESTERN KENTUCKY UNIVERSITY
                                                                                                                SUPPLY SERVICES BUILDING
                                                                                                                BOWLING GREEN KY  42101
                                                                                                                     MAIL ALL INVOICES AND
                                                                                                                     CORRESPONDENCE TO:
                                                                                                                   PURCHASING DEPARTMENT
                                                                                                               WESTERN KENTUCKY UNIVERSITY
                5. Vendor must make invoice out in triplicate.                                                    SUPPLY SERVICES BUILDING
                6. FAILURE TO COMPLY WILL RESULT IN RETURN OF INVOICE FOR CORRECTION.                              BOWLING GREEN KY  42101