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SERVICE/REPAIUTHORIZATION <br /> ll o G�C3 u��G3MOC�C� <br /> �Q4flOO a C�QNJfI�,1C��1 u C�O� ^' <br /> CALIFORNIA CONTRACTOR LICENSE]03105 A-CGIIDAR HAZ <br /> 808 N.UNION ST.STOCKTON,CALIF.95405 ' <br /> P.O.BOX NO STOCKTON,CALIF.95101 <br /> PHONE Z09M89-= <br /> SALES SERVICE . INSTALLATION OF PETROLEUM DISPENSING LUBRICATION 6 INDUSTRIAL SERVICE EQUIPMENT <br /> P.O.tl DATE <br /> AUTHORIZING NAME COMPANY NAME <br /> BUSINESS <br /> ADDRESS ._. ..: .,... ST. <br /> LOCATION .. - <br /> CIN ZIP PHONE <br /> AUTHORIZED REPAIR OF THE FOLLOWING EQUIPMENT <br /> /:I,aJ5^-., 1'e.t.''�i rc+.i '3'•,� "t''��?t,� YJc., :•..a t�v.-:>x;uL -=v ' <br /> I HEREBY AUTHORIZE THE REPAIR/SERVICE WORKTOBE DONE SY STGCKTON SERVICE STATION EQUIPMENT COMPANY <br /> INC.AS DESCRIBED ABOVE ON THE EQUIPMENT NAMED HEREON.ALL REPAIR PARTS ARE TO BE BILLED AT S.S.S.E <br /> REGULAR PRICES.I AGREE TO PAY CASH FOR SUCH REPAIR PARTS AND LABOR ON DELIVERY OF EQUIPMENT OR ON <br /> TERMS SATISFACTORY TO SS.S.E.AND UNTIL PAID IN FULL ANY UNPAID BALANCES SHALL CONSTITUTE A LIEN ON THIS <br /> EQUIPMENT.I FURTHER AGREE THAT S.S.S.E.WILL NOT BE HELD RESPONSIBLE FOR LOSS OR DAMAGE TO SAID <br /> EQUIPMENT FROM FIRE.THEFT OR OTHER CAUSES BEYOND.S.S.S.E'S CONTROL <br /> I AGREE TO BE INVOICED AND WILL BE SUBJECT TO TERMS <br /> AUTHORIZED SIGNATURE TITLE <br /> X <br /> FORM N 0015 <br /> CUSTOMER COPY <br />