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CARBON ACTIVATED CORP.

VERBAL PURCHASE ORDER – INHOUSE


CARBON / FILTER MEDIA / INTERNATIONAL

Mindy Liu
Unisix Graphene Technology Co., Ltd CONTACT PERSON: _______________________
COMPANY: _________________________________

B-209 Logistics Hub 1188 PingHai Rd, ZhaoBan


ADDRESS: ______________________________ PHONE#:Shan
(877) 337-3898 (o) 630-800-7355 (c)
________________________________
_________________________________
STREET ADDRESS FAX#: ___________________________________
Zhejiang
ZhenHai District, Ningbo CityProvince 315200
________________________________________
CITY STATE ZIP mliu@omefoods.com
EMAIL: __________________________________
China
______________
COUNTRY
NEW CUSTOMER: 
✔ YES  NO PURCHASE ORDER #: ______________
CC

TYPE OF APPLICATION: 
✔ WATER  AIR  OTHER _______________________________
1
CARBON TYPE:   COAL BASE
✔ COCONUT SHELL  OTHER _______________________
TYPE: 
✔ ACID WASHED  WATER WASHED  SILVER IMPREGNATED
 COPPER IMPREGNATED  KOH IMPREGNATED  SULFUR IMPREGNATED
 OTHER IMPREGNATION ____________________________________________________________
MESH SIZE:
QTY: # of QTY: # of QTY: # of
Price Price Price
MT/lb Bags MT/lb Bags MT/lb Bags
 4x6  12x30  1.5mm
 4x8  12x40  2.00mm
 4x10  20x50  3.00mm
 6x8  30x60  4.00mm
 6x10  50x150 Anthracite
 6x12  50x200  0.65-0.85mm
 6x16 
✔ 80x325 5 kg 1 7  0.85-0.95mm
 8x16  -325  1.0-1.1mm
 8x30  OTHER SIZE __________________________________________________

PACKAGING:  27.5lb./ 1 cub.ft. (Polypropylene Bags)  1100lb. (Super Sack Polypropylene Bags)
 55lb./ 2 cub.ft. (Polypropylene Bags)  220lb. (Fiber Drums)  OTHER ____________
5 kg container

2 SPECIAL REQUIREMENTS:

****PLEASE ATTACHED THE BANKING DETAILS AND BILL OF LOADING INTRUCTION****

DELIVERY/PICKUP: ASAP
DATE ______________ TIME ______________
SHIPPING ADDRESS (IF DIFFERENT): __________________________________________________
__________________________________________________
SHIPPING METHOD:
 WILL CALL  FREIGHT PRE-PAID & ADD  OUR TRUCK 
✔ UPS
 FREIGHT INCLUDED  FREIGHT COLLECT  3RD PARTY BILLING
 OTHER ___________________________________________________
PAYMENT METHOD: (First 2-3 shipments c.o.d. for new customers)
 C.O.D.  CHECK  BILL LATER (NET 15 / NET 30/ NET 45)
 D/P  D/A  LC  WIRE  DIRECT / PENNDING PAYMENT
 CREDIT CARD: Type: MC / VISA / American Express / Other ________________
534

5 5 7 1 
3 3 1 0 
5 9 6 7 
8 6 3 8 0 5 2 1
_____/_____ Mindy Liu - Omega Foods
_______________________
CREDIT CARD NUMBER EXP.DATE (mm/yy) NAME ON CARD

ORDER TAKEN BY: DATE: TIME:


JCH 11/15/19 9:05
FM-7.2.1-02, Rev. C

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