Tender Ref.: ME900242013 Supply of English Educational Books to the Education Bureau Annex E (Page 1 of 1) Ref. No. PURCHASING CARD FAX ORDER FORM From : Education Bureau To : (Name of responsible officer) (Attn. Tel. No. : Tel. No. : Fax No. : Fax No. : Purchasing Card No. : Expiry Date : Customer Reference ID : (17 alpha-numeric characters) ) Please supply the following items to the address shown below : Item - Description Title/ISBN Publisher Author Qty. Net Total Rate Amount % Price 1. (HK$ Delivery ) 2. % (HK$ ) 3. % (HK$ ) 4. % (HK$ ) 5. % (HK$ ) 6. % (HK$ ) 7. % (HK$ ) Estimated Total Amount : HK$ Delivery Address : Contact Person : Tel. No. : Authorised Signature: Date : Remarks for users: (1) This purchase was made through the Purchasing Card. No G.F.219 is required. Users are required to return the supplier’s delivery note, duly signed, to the responsible officer, within 2 working days after receipt of goods/services, for payment purpose. (2) For enquiry, please contact the responsible officer stated above.