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06 / 11 / 2021 3 : 04 PM FAX 2099488625 AMCE SAW 0008 / 0010 <br /> statamen RECEIPT ONLY - THIS X$,• <br /> f w. 0 P d <br /> „ <br /> SK•SS6-BOX-23 Raymond Gamer 11/20/19 13 : 09 PACE 1 <br /> CSC SK-$SL�Bb%-23 Raymond <br /> sfty - K1 eon Systems , Inc . ” x1/11/19 11 : 63 PACE <br /> 2600 N Central Expy, suite 200 <br /> Richardson , TX 75080 Vry <br /> CORPORATE: 800-669-5740 Safety - K 1 eon Systems , <br /> Inc , <br /> 24 HR EMERGENCY : 800.488.1760 ((Safety-Kleea) 2600 N Central Expy, Suite 700 <br /> 2095453011 Richardson , 7% 7508o <br /> REFERENCE WoCORPORATE : 800.6695740 <br /> •TOMER# ACIS642 Acme saw supply dia09391. 19OS767729 24 HR EMERGENCY; 800 "468-1760 y ) <br /> 1204 E Main St 9WC WEEK: 2015"47 CSafet Kleett <br /> Stockton CA 9S245 " SS14 SRVC DATE : 11/30/19 2095451011 <br /> PHONE 209-948 -6735 CUSTOMERM ACIS642 Ame Saw - Supply REFERENCE NOR <br /> ES <br /> L TO CUS7DMEA# QILI 70 ADDRESS: 1204 E Maid st 78766693 .180639848 <br /> 16091 �, I 'A47me saw Industrial Supply 5toekton CA 9S2o5 �SS34 � SRVC WEEk : x019 . <br /> r 1204 E Main St PHONE 209 -94ti•673S SRVC DA7E : 01 /11/1 <br /> �' Stockton PHONECA 0520S451437A5 BILLACIOT C01I BILL To AgOpESS ; <br /> EXEMPT# Acrne Saw Industria? Supply <br /> TAX <br /> RCHASE ORDFAIN 1204 E Main St <br /> PRODUCT/SERVICE$ Stockton CA 95205 =5514 <br /> SERVICE/ 4TOTAL PURCHASE ORDER# PHONE 209-948.673S <br /> PRODUCT QTY UNIT PRICE i TAX CHARGE PRODUCT/SERVICES TAX ExEMPTo <br /> 437 MODEL 90 W/2387 A 6365 14000 177 . 8640; 16 . 01 193087 SERVICE/ <br /> 5/N 16029471 TAG 00001170SKIOU29471 CLEAN 2 . 50 SOENT 0 . 000 PRODUCT TOTAL <br /> ARGE <br /> 90837 MODEL 90 WY2387 & 6365 Q 1 , 00 PRICEY UNIT ?s6no TAX <br /> 16 , O1� 83 , 87 <br /> SERVICE TERM 4 WEEK SCANNED YES s/N 164z9471 TAG 0oo01a7D±;Kis029473 CLBN1 2 . 54 SPENT Otago6 , <br /> 10030 RECOVERY FEE - - 1 =000+ 35 . 5000' 1 . 40 16 . 90 <br /> . . . . . . . . . SERVICE TERM 4 WEEK SCANNED NO <br /> TOTAL sERvzC6/PRhpUCTs 103 , 3600 17 . 41 210 . 77 100090 RECOVERY FEE # . Ogg #5 . 6440 3 . 40 16090 <br /> 71 CHARGE 210 . 77 TOTAL SERVIcg/pRODUCIS -,. . . � �193 . 36Oq • • • • • � � • • • _ _ . . . _ <br /> CREDITS O . QQ 17 . 41 210877 <br /> 1DTAL DUE - -- 210 . 77� � <br /> TOTAL CHARGE 210 . 77 <br /> CREDITS 0 . 00 <br /> UNPAID BALANCE THIS RECEIPT 210 , 77 Y TOTAL DUE • u ^ •210 , 77 <br /> UNPAID BALANCE THIS REI 210 . 77 <br /> iarhine clean and good condition? Yes <br /> .rang Assembly Condition Yes Machine slenn and goad condixian7 Yas <br /> lacnls in place and Tegible2 Yes <br /> ion yerp <br /> ;usable link 1nstnllad? Vas Decals in PlaceLamp Assembly oaOdtl 9iblc? Yes` <br /> bprgpncy closing of lid unobstructed? Yes <br /> 4aehine properly groundad? Yet Fusible link installedP Yes <br /> Local Phone No . Sticker Affixed to Machine Yes EmgrOency e1Q;inq of lid unobstruetad? Yes <br /> Spent solvent meets acceptance eriteriaa YesMachine properly grounded? Yes <br /> Local Phone No . sticker Affixed to Machine Yts <br /> Spent solvent meets acCaptance eriteris? Yes <br /> GENERATOR STATUS <br /> p- 220 lbs/month GENERATDR STATUS <br /> Customer eertifies that (1) the above-rtamed !materials are properly 0.220 166/month <br /> MET a .r., .r __ , a.. in nran.n rnedition <br /> Custamar terrifies that (i) the abovr . :„w,r,1 o,otarials are properly <br /> vkn"i'?icd•,• - yat:kaor.'d , ^n;Zrlcr,J'ail;fwl`�et�`J%�eti,l < brp ie <br /> a TO <br /> �Yn <br /> aIts <br /> at 4 � 6d � �c� Piyya, � <br /> '•�` � Y it • b -'I a {7' Y V � <br /> ; y - N <br /> e <br /> 4, wit <br /> Ivor <br /> ,o n o• a ±^ �` ea 4 R t� CPQ CS <br /> C R ^ C -�•• 3IIZAC• �` �7t mss" r vie <br /> Rte. CL <br /> KL �. A ^ Jilt <br /> r. .. h' x <br /> top <br /> IV IIJA <br /> 4n h.PF <br /> fie <br /> Ic m rf N 0 �q o .9 � .yi '� ik x 'I'/ <br /> r ¢ f� 44 + <br /> rt a, �npis 1y <br /> in <br /> DC <br /> Q� �a w � <br /> 31 i � n, � t�y 7a pyo <br /> e j' YA I ti t," 'C...T 4a rrt � a b o I M 4 404• /10 <br /> S, a Y. i + Y t w fp N r • tW ja "C In rV 61 �Ono <br /> k <br /> In <br /> ON <br /> PLI <br /> Air. 4n Qi .•�C Q m @ ¢ A , r <br /> + Ch to <br /> low <br /> VT 1A � x n, fly <br /> i <br />