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Seller's Confirmation of Receipt & Acceptance of Order Form

To:
______________________
______________________
______________________

Date:    __________, 20__, No._____

We hereby confirm your order for the following goods:

Item: ___________________________
Terms of Shipment: ______________
Delivery Date: __________________
Delivery Point: _________________
Terms of Payment: _______________

All prices herein are exclusive of sales, use, and other excise taxes.  All such taxes, and any other taxes measured, in whole or part, by gross receipts applicable to this transaction are to be borne by the purchaser.  All export, import and other duties, tariffs and customs shall be paid by the purchaser.  If exemption is claimed by the purchaser from any of the foregoing, the purchaser shall furnish satisfactory proof of such tax exemption.

___________________________________
SELLER

Date: ______________________________