CHEM-IMPEX INTERNATIONAL, INC.

INVOICE
935 DILLON DRIVE, WOOD DALE, IL 60191
P (630) 766-2112 | F (630) 766-2218
E-mail: customer@chemimpex.com
INVOICE # INV0463786
Website: www.chemimpex.com Page 1/1
REMIT TO:
BILL TO: SHIP TO:
Labstore SRL CHEM-IMPEX SDQ695633 LABSTORE SRL
INTERNATIONAL, INC.
Jacqueline Fernandez Jacqueline Fernandez
Vistas del Arroyo II 2250 NW 114th Ave
D104 3405 PAYSPHERE CIRCLE Unit 1A
Santo Domingo CHICAGO, IL 60674 (USA) Miami, FL 33192-4177
Santo Domingo Norte, - 11201 P: 8492132209
Dominican Republic
P: +1 849-213-2209

Purchase Order # Customer ID Shipping Method Payment Terms Invoice Date Order
CREDIT CARD L0253 FEDEX GRD PPD CREDIT CARD 6/22/2023 WEB164153

Quantity Quantity Quantity Extended

Ordered Shipped BO UOM Item Number Description Price Price
2 2 0 EACH 00746-1KG Potassium phosphate monobasic, anhydrous $35.00 $63.00
Lot: 002126-144019291

1 1 0 EACH 01213-1KG Ammonium phosphate monobasic $68.20 $61.38

Lot: 000514-20204003

1 1 0 EACH 35877-1KG Sodium phosphate monobasic $35.00 $31.50

Lot: 002251-01819

Tracking Number: 574774446250

Incoterms: Ex-Works

Wire Transfer Instructions: Name: Jacqueline Fernandez Subtotal $155.88

Bank of America Email: acamejo@labstorerd.com Misc $0.00
540 W. Madison Phone: 8492132209 Ext.
Tax $0.00
Chicago, IL 60661 (USA)
Freight $18.98
ABA#: 026009593
SWIFT BOFAUS3N | A/C #: 5201624250 Trade Discount $0.00
Total $174.86

FOR LABORATORY USE ONLY, NOT FOR DRUG USE

ORDER ONLINE AT WWW.CHEMIMPEX.COM
CERTIFICATES OF ANALYSIS & SDS ARE AVAILABLE ON OUR WEBSITE
Unless governed by a separate written agreement, sales are subject to Chem-Impex standard terms and conditions. Visit www.chemimpex.com for complete details.