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SERVICE/R EPAIR AUTHORIZATION <br /> IMUIX"ONUMM <br /> CALIFORNIA CONTRACTOR LICENSE 309105 C-61,SA t <br /> 806-820 N.UNION ST.STOCKTON,CALIF.95205 I <br /> P.O.BOX 508 STOCKTON,CALIF.95201 <br /> PHONE 209/464-8333 TAX I.D.#94-1573741 !! <br /> 7 <br /> SALES • SERVICE • INSTALLATION OF PETROLEUM DISPENSING a LUBRICATION&INDUSTRIAL SERVICE EQUIPMENT <br /> { <br /> DATE <br /> P.O.It <br /> AUTHORIZING NAME COMPANY NAME <br /> i <br /> C 4�c <br /> BUSINESS ADDRESS �r �1ST. <br /> LOCATION `> <br /> CITY ZIP PHONE <br /> AUTHORIZED REPAIR OF THE FOLLOWING EQUIPMENT <br /> A-1V % i <br /> „re7 > <br /> f <br /> v <br /> S-e rV ! C. <br /> I HEREBY AUTHORIZE THE REPAIR/SERVICE WORK TOSS DONE BY STOCKTON SERVICE STATION EQUIPMENT COMPANY <br /> INC.AS DESCRIBED ABOVE ON THE EQUIPMENT NAMED HEREON.ALL REPAIR PARTS ARE TO BE BILLED AT S.S.S.E. <br /> REGULAR PRICES.I AGREE TO PAY CASH FOR SUCH REPAIR PARTS AND LABOR ON DELIVERY OF EQUIPMENT OR ON <br /> TERMS SATISFACTORY TO S.S.S.E.AND UNTIL PAID IN FULL ANY UNPAID BALANCES SHALL CONSTITUTE A LIEN ON THIS <br /> EQUIPMENT.I FURTHER AGREE THAT S.S.S.E.WILL NOT BE HELD RESPONSIBLE FOR LOSS OR DAMAGE TO SAID <br /> EQUIPMENT FROM FIRE,THEFT OR OTHER CAUSES BEYOND S.S.S.E'S.CONTROI <br /> I AGREE TO BE INVOICED AND WILL BE SU SCT TO TERMS. <br /> H RIZErIG NTITLE <br /> RM q"oo�r OFFICE COPY <br /> i <br />