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Oct 26 2010 7: 36AM COX BROS TIRE SERVICE 8350401 p. 3 <br /> NVOICE <br /> AFSE <br /> 28919 <br /> 21 Abir is Je & Safety Equipment SHIPPED VfA: Author zed _, O Phoned In By: DATE: <br /> 116 .5c 51 E16 French Camp Road 7" <br /> R1p lififornia 95366-9728 PURCHASE IC�r.8cl <br /> ORDER CHECK C:) <br /> Cc <br /> IAANMCA/STOCIaO 1 TRACY LOD] SERVICE TECHNICIAN CUSTOMERS PHONE # <br /> (209) 982-9466 ?6) 835-4584 (209) 368-0101 <br /> JOB LOCATION []SHIP To <br /> ti <br /> fi <br /> ?K'Annual Maini 7-1: �erni Annual Insp. I Quarterly Insp. <br /> 0 Monthly Insp. <br /> C3 Service Ca <br /> FIRE EXT1NGLJJ$HE*$FRVICE (NONTAXABLE) MERCHANDISE&MATERIALS (TAXABLE) <br /> QTY DESCOUPTI(M UNIT AMT. <br /> QTY DESCRIPTION UNIT I AMT1 <br /> I)Cmaint4janc,41 1: lbs. . CO2recharge <br /> 5# DCmaintiltlapt;4 : -- <br /> .1 1 lbs. CO2 recharge <br /> 10* DC maint coli i! CartridcLe exchanges <br /> DC Rech%lad ClIllesn- New 'Fire Ext, <br /> 5* DCRechg.& lhlirftl �l New 0 Fire Ext, <br /> 1 101 DC Rechhg. Chile I'i — <br /> New Fire Ext <br /> Class K Minten a <br /> O-Rings Inst. (small) <br /> CO2 maintenan <br /> O-Rings Inst. (larcle) <br /> Halogenated ma teracl?' <br /> I ad-Rin <br /> ite a e <br /> DC 6 yr.rp4i]I isc Pull Pins Inst. <br /> 5' DC 6 yr.ma!*n in a --z;;. 4n Wall Bra <br /> 10' DC 6 yr. rini tea c Brackets <br /> t tr–i Press Gaucte Inst. <br /> DC Hydrotest <br /> Valve Stem Inst <br /> CO2 Hydro <br /> test <br /> Maintenance Ta (s) <br /> Halogenated Hy, si. Service Collar(s) <br /> Service call (0 PJ H drotest Label s) <br /> Disposal fee 1i <br /> . i <br /> I <br /> �Iil I <br /> Service Done 30 P if re Due <br /> Offered To Retur e d Parts <br /> .1 <br /> LE)SUB TOTAL 4XAB SUB TOTAL TAXABLE: <br /> TAX: <br /> AFSE provides no ielkagelpas, <br /> ;14 ari on plastic head fire extinguishers. We exercise extreme caution and use only approved NON TAXABLE: <br /> materials in servicing an ecli We assume no liability for malfunction or tampering. All above work is performed in <br /> accordance with NFPA 10 al C Is. z nia Administrative Code Tide 19. Inspection and maintenance me performed only with TOTAL: <br /> SUB"TOTAL TAXABLE: <br /> , <br /> prior approval. Final i 0.1. as i!lze, type, location and installation of extinguishers is with approval of customer and/or <br /> authority having jurisdiction.I ett 30 days a finance charge of 2%per month APR 24%(minimum monthly charge$2.00) <br /> will be charged on all pall COD, <br /> Itis hereby agreed ofpropeTty listed ab NET TOTAL: <br /> until paid in full. I all remain Property of APSE <br /> RECEIVED IN GOOD ORDER"D A" FrED BY X <br /> pit i.'i <br /> -7 <br /> 69 <br />