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022083 <br /> R&M Work Order Store Number or City/State <br /> CkAttention Manager. ta ' t <br /> r Compiete this form for every R&M invoice. <br /> Record the service call in the Repairs&Maintenance Log. BIG SKY Work Order# <br /> 7is°a s`° a Al!invoices must include a completed R&M Work Order form and <br /> co«a�yrs <br /> BIG SKY Work Order number to be considered for payment Ms e- � 2,Us��e theBIG SKY Work Order number as the PO#on invoice <br /> Service Company: �? t`- I Invoice/Service Ticket Number: <br /> Technician Name: 1 '� � ±�' ic ;Date Work Performed: r <br /> Detailed description of work performed&equip ent type: <br /> � 2 'i �r <br /> � <br /> Parts/Materials Used On Site Labor <br /> Quantity Description Start Time End Time Total Hours <br /> pr ` 9i 1 <br /> Store Represen0it e-Signature Date Store Represe alive-Print Name <br /> 1 hereby acknowledge the satisfactory completion of the above described work and further acknowledge <br /> the materials and time involved are accurate as represented <br /> Original Copy to Vendor/invoice and Carbon Copy to Store Manager Love's Corporate Office: <br /> This R&M Work Order(the"Work Order")and the Terms&Conditions printed on the reverse side of (800)388-0983 <br /> this document,shall govern your conduct,responsiblities,and obligations in relation to the services Send Invoices to: <br /> provided,materials used,or parts used. Vendor agrees that it has familiarized itself with and accepted PO Box 26210 <br /> the terms of this Work Order,including without limitation,the Terms&Conditions,and acknowledges Oklahoma City,OK 73126 <br /> Vendor's acceptance of same by its provision of services,materials or parts. or <br /> Love's R&M Work Order must accompany invoice and lien waivers(as per State requirements) elm:APInvoices@Loves.com <br /> to be considered for payment. fax.-405-242-2617 <br />