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Waste Management 1 llV1C 11L tc r•1 1v lJ. r <br /> Industrial Services, Inc. DAY F'` .7 s, <br /> ln� � <br /> 4501 California Court Phone(707)745-0501 TODAY'S DATE <br /> Benicia,CA 94510 Fax(707)745-0510 W O# � <br /> ,('USTOMER i Cis CONTACT <br /> t1VIT P.O.# PROJECT COMPLETED YES OR NO <br /> JOB DESC: T&M BID 20K UNIT RATE CERT P/R CIRCLE ONE). <br /> : <br /> EMPLOYEE unaa3TD B NB OFFICE USE ONLY <br /> I1Vff- CLASS EMPL.# LAST/FIRST NAME START OUT STOP: TOTAL TRAVEL ST OT DT TRAV <br /> i' <br /> INITIALS AFFIRM ACCURACY OF TIME AND NO UNREPORTED INJURIES OR INCIDENTS <br /> EQUIPMENT QTY HRS OFFICE USE ONLY EQUIPMENT QTY HRS OFFICE USE ONLY <br /> CDDE5 CODES ary <br /> K @ H/B PUW# 2 WAY RADIOS - 3041 <br /> K @�H/B PUMP# LEVEL ENSEMBLE R/D <br /> BBL.VAC.TRK.# SAFETY HARNESS 3134 <br /> €1 BBL.VAC.TRK.# _ : GAS METER <br /> TURBO-VAC# BLOWER <br /> G177. -ER# HIGH PRESS.HOSE 3083 <br /> ['A11AFL# "AIR/FIRE HOSE <br /> "AIR/FIRE HOSE <br /> GEAR TRUCK# 1"LOW PRESS.HOSE 3086 <br /> C.F.M.COMP# "VAC HOSE <br /> "FLEX LANCE "VAC HOSE <br /> "FLEX LANCE 12V LIGHT BULBS 3111 <br /> 30 MIN AIR PACK-SOBA 3029 12V TRANSFORMER 3112 <br /> RESPIRATOR TYPE G.F.C.I. 3113 <br /> CARTRIDGES TYPE 12V LIGHTS 3114 <br /> DUCT TAPE 3166 M- DIAPH.PUMP <br /> VLSQUEEN J <br /> NOTES <br /> By authorisation of the time ticket the purchaser and his agent or representative agrees for the } •�; J <br /> purchaser,to the following ternis-and conditions: ►, '� 1!. rl / <br /> Payment terms:net 30 days. t - <br /> ENTATIVE <br /> In the event that collection and I or suit shall become necessary to enforce the provisions of the <br /> cordmct,or the payment due hereunder,the contractor shall.be entitled to add to the-amount due for r, <br /> all collections fees r CUSTOMER REPRESENTATIVE <br /> (3)15%iotexest per month will be charged on accc�l.nts over 30 days.Annual percentage rate 18%. <br /> INVOICE ' <br />