Fresh Mart Grocery
120 Market Street, Springfield, IL 62701
+1 (555) 010-7788 · hello@freshmart.example.com
EIN
84-2213907
Invoice
INV-2026-0147
Issued Sep 22, 2026
Due Oct 06, 2026
Bill to
Fresh Bites Café
400 Commerce Blvd, Suite 12, Springfield, IL 62701
+1 555-010-4471
orders@freshbites.example.com
Ship to
Fresh Bites Café
Loading Dock B, 400 Commerce Blvd, Springfield, IL 62701
PO ref
PO-FB-5521
Terms
Net 14
Salesperson
Nisha Patel
Status
Partially paid
| # | Item | SKU | Qty | Price | Disc. | Tax | Amount |
|---|---|---|---|---|---|---|---|
| 1 | Basmati Rice 5 kg | GR-BAS-0507 | 20 | $24.90 | 5% | 5% | $496.76 |
| 2 | Extra Virgin Olive Oil 1 L | PN-OLV-1000 | 12 | $11.90 | — | 5% | $149.94 |
| 3 | Whole Milk 1 L | DR-MLK-0101 | 60 | $1.80 | — | — | $108.00 |
| 4 | Cheddar Block 400 g | DR-CHD-0400 | 18 | $6.50 | 10% | 5% | $110.57 |
| 5 | Roma Tomatoes | FR-TOM-0018 | 25 | $2.80 | — | — | $70.00 |
| 6 | Ground Coffee 500 g | BV-COF-0500 | 10 | $9.40 | 5% | 5% | $93.77 |
Tax breakdown
| Rate | Taxable | Tax |
|---|---|---|
| Sales tax 5% | $810.50 | $40.53 |
| Exempt (0%) | $178.00 | $0.00 |
| Total tax | $988.50 | $40.53 |
Payment information
Scan to pay $644.05First Prairie Bank · Acct 0042 7788 91
Routing 071 000 288 · Ref INV-2026-0147
Subtotal$1,029.80
Discount-$41.30
Tax$40.53
Shipping$15.00
Round-off+$0.02
Total$1,044.05
Paid — Card (Sep 22)-$250.00
Paid — Bank Transfer (Sep 23)-$150.00
Balance due$644.05
Terms & conditions
- Payment is due by the due date shown above.
- Late payments may incur a 1.5% monthly fee.
- Perishable goods cannot be returned after 24 hours.
Nisha Patel
Authorized signature
