(Returns And Correspondence) Phone: 248/848-3800 Invoice Date Invoice No.

American Concrete Institute Fax: 248/848-3801

1/2/20 0090604127
38800 Country Club Drive http://www.concrete.org
Farmington Hills, MI 48331-3411 TDD: 248/848-3823
USA
INVOICE

BILL TO: SHIP TO:

Mr Fernando Rosales Zapata
Mr Fernando Rosales Zapata
Control Mix Express SAC
Control Mix Express SAC
Bajada Balta 169 Of 801 Miraflores
Bajada Balta 169 Of 801 Miraflores 2000 Lima
2000 Lima Peru
Peru

Customer No. ACI Order No. ShipVia PO No./Customer Order No. Terms
01824903 9000521904 EDWNLD Net 30

Qty B/O Shipped Order Code Title/Description Unit Price Amount

1 0 1 29418158 ONLINE - ACI Concrete Repair Subscription 02-Jan-2020 to 31-Jan-2021
$99.00 $99.00

CHECK Send payments to:

American Concrete Institute
ALL PAYMENTS MUST BE MADE IN U.S. FUNDS 38800 Country Club Drive
DRAWN ON A U.S. BANK. Farmington Hills, MI 48331-3439
Cardholders Name USA

Card Number
Expiration Date CSV You may now pay invoices
ONLINE at www.concrete.org
CC Holders Signature
when logged in with your
Keep Credit Card on File username and password. From
the homepage, click My Orders.
CC Bill Address 1
CC Bill Address 2 Sub-Total $99.00
CC Bill City State Zip Tax $0.00
P&H $0.00
FI: #38-0296490
Total Amount $99.00
Canadian GST: #R126213149RT001
Amount Paid $99.00
DUNS# 069824167
Balance Due $0.00
Order# 9000521904