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SVC NO: 6370 <br />DATE: �? TECHNIICIIAN: <br />��aw <br />4688 W. Jennifer Ave., #101 <br />Fresno, CA 93722-6418 <br />(559) 276-5410 / Fax 559-277-0106 <br />NAME OF SITE: JLr_51Wnd1d0 M� i M _ .4 BILLING NAME: A <br />0 AP <br />❑ WSE <br />L1 other <br />ADDRESS: <br />10 o�M _ <br />ADDRESS: <br />OleCONTACT: <br />z_a 0 <br />I< <br />SITE PHONE N0: <br />- <br />BILLING PHONE N0: <br />CUSTOMER PO#: <br />EQUIPMENT SERVICED: <br />SERIAL NO.: <br />INSTALL DATE: <br />CORRE TIVE ACTION TAKEN: <br />�} <br />COMPLAINT: <br />5 lie <br />EQUIPMENT SERVICED. <br />SE AL NO.: <br />INSTALL DATE: <br />CORRECTIVE ACTION TAKEN: <br />COMPLAINT: <br />PART NO. <br />DESCRIPTION <br />SERIAL NO.AAN <br />it <br />_ <br />Vt r <br />S.�'4'S.. `e r ` M' �.' .• ."F'z i' . <br />I 7� <br />� <br />s <br />v, <br />s - <br />3. <br />it dS_.ni.�ei. 'Si ny:'`6lTrt_ 'r S Y <br />y <br />.'s+ y.�Nis.�rETG ,r <br />ILR�? <br />3 <br />I <br />r <br />It <br />YT.f.�.� Y .-E.R.r' t .firT �SW�:,t���- <br />kt(Lb-sx ^'>'f T�:.r <br />l <br />Lt'::.'!i� <br />51 sa cC. 'm4 <br />+A x s i�i. 2 <br />�' t z.e: � � �.• .fir t .. "s;.y,s. Fd� '. ...,, .-.. �' <br />Marirma <br />'►� r . <br />MIf.. fl' <br />1 clearly understand and agree that all services are charged directly to me and that I am personally responsible for payment. i understand that It I <br />suspend or terminate work, all fees for services will be Immediately due and payable. In the event of my default of payment, I promise to pay legal Interest on the indebtedness <br />together wI0 such collection costs and reasonable attorney fees s m r quired to effect collection. <br />DATE -CUSTOMER'S SIGNATURE PRINT NAME <br />: <br />7 <br />