ZAMÓWIENIE no.: 07/09/2015/ZAM Put on display on 22-09-2015

SELLER

BUYER

Centrum Słuchu i Mowy Sp. z o.o. ul. Mokra 7, Kajetany, 05-830 Nadarzyn Tax ID: 522-259-53-96 Telephone 22 887 86 12, Fax: 22 887 60 21 e-mail address [email protected], www.csim.pl

Daniluk Denis , Belarus

Date of sale 22-09-2015 Mode of payment Transfer Payment deadline 30 days (22-10-2015) To this account Pekao S.A. SWIFT:PKOPPLPW PL36124010401978001006644809 SN Name of goods or service 1 Cochlear Implantation

PKWiU symbol

Wey

32.50.23.0

szt

Total amount 29 500.01 €

In words

Qty

Unit price 1

Value without tax

27 314.82

27 314.82

Total

27 314.82

Including

27 314.82

VAT VAT amount % 8%

8%

2 185.19

29 500.01

2 185.19

29 500.01

2 185.19

29 500.01

( twenty-nine thousand five hundred euro and one c.) Comments

THANK YOU AND PLEASE COME AGAIN!

Signature of the person authorised to receive the invoice

Signature of the person authorised to issue the invoice

This document was generated by Faktura VAT 2013 START www.rafsoft.net

Value with input tax

Faktura VAT 2013 START

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