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objednat.txt
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1999-10-12
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Admiton, s.r.o., Resslova 20, 301 35 Plze≥, ╚eskß Republika
bankovnφ spojenφ: IPB - 152571283/5100 I╚O: 25232550
Tel.: 019/716 5151 Fax: 019/716 5152
e-mail: sales@admiton.cz Web: http://www.admiton.cz
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-=-=-=-=-=-=-=-=-=-=-=-=-=-=--=-=-=-=-=-=
Objednßvka produktu Admiton WinKeys 2000 CZ
-=-=-=-=-=-=-=-=-=-=-=-=-=-=--=-=-=-=-=-=
1. ┌ D A J E O O D B ╠ R A T E L I
A. Kontaktnφ osoba
Titul: ______ JmΘno: _____________ P°φjmenφ: ________________
Nßzev firmy: ____________________________________________________
B. FakturaΦnφ ·daje (sφdlo firmy podle obchodnφho rejst°φku)
Ulice: ___________________________________________
M∞sto: _________________________ PS╚: __________
I╚O: ___________________________ DI╚: _________________________
E-mail: _________________________________________________________
Telefon: ___ / _________________ Fax: ___ / ___________________
C. ┌daje pro zaslßnφ (nenφ-li adresa toto₧nß se sφdlem firmy)
Ulice: ___________________________________________
M∞sto: _________________________ PS╚: __________
2. O B J E D N ┴ V K A
A. Slevy
[ ] 10% pro neziskovou organizaci
[ ] 15% pro vzd∞lßvacφ instituci
[ ] 15% pro novΘ dealery
B. Zßvaznß objednßvka licencφ
[ ] program Admiton WinKeys 2000 490,- KΦ poΦet: _____
[ ] u₧ivatelskß p°φruΦka a datov² nosiΦ 150,- KΦ poΦet: _____
Celkovß cena: _____ KΦ
3. P L A T B A A D O D ┴ N ═
A. Zp∙sob platby
[ ] dobφrkou p°i p°evzetφ produktu
[ ] bankovnφm p°evodem na nßÜ ·Φet "IPB - 152571283/5100"
[ ] poÜtovnφ poukßzkou
[ ] platebnφ kartou
[ ] Üekem
B. Zp∙sob dodßnφ (ve vÜech p°φpadech bude zaslßna faktura)
[ ] e-mailem pouze aktivaΦnφ ·daje (pouze p°i platb∞ p°edem)
[ ] p°epravnφ slu₧bou
[ ] poÜtou
C. ┌daje p°i ·hrad∞ platebnφ kartou:
Typ platebnφ karty:
[ ] VISA [ ] Eurocard/Mastercard [ ] American Express
[ ] JCB [ ] Diners Club International [ ] ╚eskß spo°itelna
╚φslo platebnφ karty: _____________________________________________
Batch Code: ______ RodnΘ Φφslo: __________ / _____
(pro karty American Express) (pro karty ╚eskΘ spo°itelny)
Platnost karty (m∞sφc/rok): ____ / ____
Dr₧itel karty: ____________________________________________________
Adresa dr₧itele karty: ____________________________________________
4. P O Z N ┴ M K Y A P ╪ I P O M ═ N K Y
5. R A Z ═ T K O A P O D P I S
(v p°φpad∞ platby kartou nutn² podpis dr₧itele karty)
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