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r <br /> OOTH�vItLL7�tFIREROTEA"' <br /> PROTECTION, INC. o CHECK# ERMS N Ann O Shop <br /> O CASH ❑CREDIT CARD onthly D Emergency <br /> 5948 King Road C-10#998129 ❑Semi Annual NFPA <br /> Loomis, CA 95650 C-16#783132 • Lic.# E-2376 916.663.3582 <br /> BILL TO: JOB SITE: DATE SERVICE TEC <br /> NAME NAME &,1ZL- <br /> ADDRESS ADDRESS Zyes 0, Loui S E Allf- TIME IN TIME OUT <br /> CITY ST ZIP CITY /�War-A ST CA ZIP y� P/0 <br /> jj <br /> O CONTRACT <br /> ,� <br /> CONTACT PH CONTACT aA 1006Z- PH 20' q -L/goLl <br /> FIRE EXTINGUISHERS: <br /> QTY FIRE EXTINGUISHER SERVICE PRICE AMOUNT QTY PRICE AMOUNT NOTES: <br /> PW-2.5G/K-CLASS MONTHLY INSPECTION <br /> 1Q2-5 <br /> /BC/HALOTRON/CO2 EMERGENCY SERVICE CALL <br /> ( )5 ( )10 ( )20 ( ) QTY FIRE SUPPRESSION PRICE (AMOUNT <br /> ABC/BC/HALOTRON/CO2 - ___-_._.... ._.._...._... <br /> ( )2.5 ( )5 ( )10 ( )20 ( ) SYSTEM SERVICE It is expressly understood and agreed that the property descriped herein shall remain the property of <br /> EXTRA TANKS Foothill Fire Protection,Inc.until its balance,include service connected with sale,shall be paid in full and <br /> ` ABC BC/HALOTRON/CO2 that the company retains the right to recover and remove any such equipment sold under the service <br /> I )2.5 ( )5 ( )10 ( 20 ( ) LINKS ( )360 ( )450 ( )500 order or invoice.Expressly excluded from this provision is any equipment sold or furnished by Foothill <br /> Fire Protection,Inc.,but merely serviced by said company.Late fee of$5 Per month over 30 days.$25 <br /> ABC/BC/HALOTRON/CO2 CAPS ( )METAL ( )FOIL SEALS NSF fee for bounced check.I agree to pay costs and attorneys'fees incurrec collection of this bill. <br /> ( )2.5 ( )5 ( )10 ( )20 ( ) RUBBER CAPS <br /> CO2 HOSE CHECK ❑ SERVICE PERFORMED WITHIN 30 DAYS OF DUE DATE <br /> QTY HYDRO TESTING/6-YEAR PRICE AMOUNT <br /> ❑ SERVICE PERFORMED MORE THAN 30 DAYS BEFORE DUE DATE <br /> DRY CHECM&HALON 5/12YR — INITIAL onTe <br /> ( )2.5 ( )5 ( )10 ( )20 ( ) QTY FIRST AID SUPPLY/MISC.EQUIPMENT PRICE AMOUNT <br /> HALON 6YR TEARDOWN �' <br /> i ii <br /> ( )2.5 ( )5 ( )9 ( )13 ( ) SUBTOTAL <br /> PW&K-CLASS <br /> ( )2.5 GALLON ( )6 LITER 77" <br /> ( )5 ( )10 ( )15 ( ) l ) TOTAL $ - <br /> 6 YR.MAINTENANCE <br /> ( )2.5 ( )5 ( )10 ( )20 <br /> QTY PARTS PRICE JAMOUNT PRINT NAM <br /> CO2DRY CHEMICAL T <br /> CO2 RECHARGE T ` <br /> SIGNATURE <br /> NECK 0 RINGS T <br /> VALVE STEMS-NEW/REBUILT T <br /> PULL PINS T Please Remit to: <br /> 195 PRESSURE GAUGE T 5948 King Rd., (Loomis, (3A 95650 <br /> GLASS/PLEXI REPLACEMENT T <br />