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ARCO'Petroleum Produ� , Company Ai Field OrderlInvoice <br /> Division of AtlanticRichfieldCompany No. 112601 <br /> Field Order (Date - ) ❑ Invoice (Date ) <br /> Seller or Contractor For materials delivered to or services performed <br /> for ARCO Petroleum Products Company <br /> Name At:Facility no. <br /> AZ24—n✓,� 6a2 2 <br /> Street Street <br /> City,state,zip code City,state,zip code <br /> Description of services performed: <br /> 6✓L wAeezgi e <br /> 1/1 e4l A—IVZ:�Zy' <br /> — ��?'P//��M s 7 /�l�✓� /L1�I/fir 5:iZZ-a �e r <br /> le efell':Se <br /> /)A c c gi b s,'' Ad 4t 4f+Rlr <br /> 6V <br /> Materials <br /> Quantity Descriptions Unit cost Amount <br /> Sales tax <br /> Material cost <br /> Labor-(mechanic,helper,laborer) Hours <br /> Travel Labor Total Rate hour Amount <br /> AAu'thoriz d b JInspected by: Completion date: Seller or Contractor Labor cost <br /> L- Total cost <br /> Address all correspondence to: NOTE:In executing this order, <br /> the Seller or Contractor agrees <br /> to the Terms and Conditions <br /> on the reverse side hereof. <br /> Blanket Contract No. (No invoice can be paid without the Blanket Contract No.) <br /> APPC-3063 Front <br /> (4-81) <br /> 1. INVOICE/ACCEPTANCE COPY <br />