Laserfiche WebLink
05/11/2005 11:23 FAX 209 932 0010 K&D wIYaAauX.AaiuY <br /> 185956 RETAIL SERVICE ORDER MERCHANDISE INVOICE Date /18, / O <br /> 1-600-226-7672 <br /> /\��'[// MAY i i z�u5 fr AMOUNT <br /> ® CAMPORA PLANT RECEIVED BY <br /> PROPANE SERVICE CUST.n10./ZO�_ E • . CE AMOUNTr <br /> I I <br /> CUSTOMER , <br /> NAME <br /> ADDRESS <br /> I 1 I <br /> rr�- 1 I I <br /> ❑CASH ❑CHARGE LJ SUBJECT <br /> RETURN RECEIVED <br /> CONTRACT ATTACHEDF CREDIT C ON ACCOUNT <br /> DIRECTIONS I 1 1 <br /> I I <br /> I I <br /> I I <br /> 1 I <br /> SERVICEIMNIDONAN D YES IsmP D YES PACE D RRM <br /> AOREEMEMMCpITMCT D HD READY! O NO WON ]ESTAMTE I 1 <br /> 1 I <br /> INSTRUCTIONS 1 <br /> I <br /> SUB-TOTAL ' <br /> DESCRIPTION OF •- <br /> 0I �v�c <br /> 1 r <br /> I <br /> I 1 <br /> _ I <br /> wrE MTE AAL DATT <br /> ORSFREO _/_/_ IROMSlD_/_/ or.L er cawrtTANK SIZE TANK SERIAL NO. PERCENT[IN TANK <br /> 1 <br /> I <br /> % - <br /> I � <br /> NOCHECK I✓1 CHECK READING <br /> C TANK INSTALLED C METE.LOCKED - _ <br /> CTANK REMOVED C METER INSTALLEDIF SALES TAX <br /> ❑TANK DISCONNECTED u METER REMOVED -- E%EYPi I✓I L'IECK _ RESELLER GOVT ['.OTHER <br /> EQUIPMENTAPPLIANCES AND • SALES TAX % <br /> RESELLER PNWIT <br /> ITEM MAKE MODEL NO. SERIAL NO. AGE _M) • • • J�i^T/r Gc <br /> �\PfR5pf59G-f/-' FE <br /> — -- -- <br /> THE WORK DESCRIBED HEREON HAS SEEN SA CTONLLT'CONILETEO ANDOPEAAINNOFj <br /> EOMPMENT EXFLAIIED.TJLE TOM EOu WT EMAINS WRH$FLIER DNTR R1m NFlILL <br /> CKGiEO 0 YES • NCES.mft�a YES y /•/ -._ j <br /> E iIYEN flLECN WCp___ - Rl11 LE•Vt3 p NO SATSf•CtORKY 0 NO X <br /> TERMS:PAYMENT IS DUE ON RECEIPT OF THIS INVOICE CUST 'S SIGN RE <br /> WHITE-ACCOUNTING COPY YELLOW-CUSTOMER COPY PINK-PILE COPY BLUE-BATCH COPY <br />