(1) The name and address of the vendor and purchaser;
(2) The date delivered;
(3) The quantity delivered and the quantity upon which the price is based, if this differs from the delivered quantity;
(4) The identity of the goods or commodities in the most descriptive terms commercially practicable, including any quantity representation made in connection with the sale; and
(5) The count of individually wrapped packages, if more than one.
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