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rF"la4w�y'JtIEW�tY",w' xi yk 4i <br /> ..r <br /> 187 Vanderbilt Cir. #2 <br /> CalWornia <br /> Manteca, Ca 95337 <br /> Office: 209-239-5587y <br /> s Fax: 209-239-6316 <br /> Coolant Service <br /> v} +r. <br /> " INVOICE NO 15554 <br /> Customer <br /> 4 Name A�.. Nom, Date of Service <br /> Address Rep P.O. # <br /> itY �,y7Ecte Zip erms ust# <br /> PhoneContact Person: <br /> aG9- :7, 7/ <br /> •D • AMOUNT <br /> t 110 50/50 Automotive Antifreeze <br /> 120. 50/50 Heavy Duty/Phosphate(Free Antifreeze) <br /> 130 Non-Diluted Automotive Antifreeze <br /> r <br /> 140 50/50 Long Life Antifreeze <br /> 117, 6 <br /> Tank Serial Numbers: Non Taxable Sub Total <br /> G s j Taxable Sub Total <br /> Tax <br /> i <br /> TOTAL DUE <br /> Customer Authorization: �/ I�a � X Date: ? X <br /> CCS Representative: „ —'- �� �" Date: <br /> All returned checks are subject to a$15.00 Service Charge. <br /> All amounts not paid within 30 days of invoice are subject tot '/a% Interest per month,18%annually on unpaid balance. <br />