Date: [date]

To: [shippers name & address]
   _______________________________
   _______________________________
   _______________________________

Order No.: [purchase order number]

Dear [name]:

You are hereby requested to confirm our order dated [date], 19XX, and provide assurance of your compliance as required under the Uniform
Commercial Code. Please specify the shipping arrangements for the ordered merchandise.

Failure to provide adequate assurance of performance shall be considered a breach of this contract, and we no longer will consider ourselves
obligated under the contract. Further, you will be held responsible for any damages under the Uniform Commercial Code.

Please acknowledge in writing, the confirmed shipping dates, by [date], 19XX.
 

        Sincerely,
 

        ___________________________________