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AtianticRichfieldCompany Work Acknowledgem <br /> l onoon OSE z O v ASF <br /> L �,��, <br /> Faarty number <br /> Contract work orOer or authonzateon number <br /> On Date work was done at this <br /> location by: <br /> Scf,�Co <br /> Contractor name <br /> Aooress <br /> The contractor had—/—personnel here for approximately hours <br /> and worked on: <br /> FU4,/7-��n/j7��Tp,�/ ��F � ���, 7f�7`. <br /> W�.0-•Cly � �.� `��n<*�.-rt�-r�'T- L,�'� <br /> Sgnature of oealer or hes employee / Date <br /> Signature of-dealer (or employee)does not obligate dealer in any way, nor <br /> does it signify any approval of any work done. <br /> ,Contractor is responsible for filling out this form and obtaining signature. Any <br /> invoice for work not covered by a separate contract at a firm price must be <br /> accompanied by a completed copy of this form. <br /> ARCO.-1499 <br /> (7•n) <br />