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06 / 11 / 2021 3405 PM FAX 2099488625 AMCE SAW 0008 / 0010
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<br /> SAE-BOX- 22 tvurtney L ] gne% Ob/09/2p 08: 36 PAGE 1 CSG8K � B8L — BOX� 29 OWeneAllOn 00 -20 - 202009;68 PAGE
<br /> Safety - Kleen Systems , Inc . Safety - KleenSptems, InO.
<br /> 42 Longwater Drive 42 Longweter Drive
<br /> Norwell , MA 02081 Notwell , MA 02061
<br /> CORPORATE % 890.869 -5740
<br /> 24 HR EMERGENCY ; 800 -468 .1740 CSefe:ty-Klean) CaRPORATE : 8D0 - 669 - 6740
<br /> 9143664999 REFERENCE ABR . 24 HR EMERGENCY: 500 ,4691760 (80(atV ^ Kleeo)
<br /> ERN FOW14 Folsom Lawn And Power Equirment s9279296 -z0Oz4197s1 2096461011
<br /> 1128 Sibley Sp Ste L SRVs` WEEKI 2020.24 REFERENCE NORI,
<br /> Folsom CA 956303506 SRVC DAYL: 06/09/20
<br /> PHONE 916 " 351 -9133 CUSTOMER# 0016642 A4m8 Seer p supply 63942720 " 2004014960
<br /> O CUSTOHERIP BILL TO ADDRESS : 1204 E M819 St
<br /> 1 A"IP Saw Industrial Supply
<br /> L204 E Main it Stooklon CA 96206 - 5614SRUC WEEK : 2020 - 35
<br /> Stockton CA 95205 . 5514 PHONE 209 - 940 - 6796 ERVC DAT826- 2020
<br /> PHONE 209 -9486735
<br /> SE DRDERIF TAX EXEMPTA • E: 0
<br /> PRODUCT /SERVICES TOTAL
<br /> TOCUBTOMER# BILL TOADDHESS
<br /> rCCE/ A016091 Aome Sow fnduelrl6l Supp{y
<br /> )UCT ATY UNIT PRICE TAX CHARGE"
<br /> 1204 E Ma1n 81
<br /> MODEL 90 W/2387 111 6365 1 .000 27S . 0000 21 . 31 196 . 31 Swim CA 96206 - 6614
<br /> S/N 17030338 TAG 00001170SK17030139 CLEAN 2 . 50 SPENT "DO
<br /> SERVICE TSRH 8 WEEK SCANNED NO PHONE 209940 - 6786
<br /> 0 RECOVERY FEE 1 , 0Gp 13 . 7500 1 .07 14182 PURCHASE ORDER# TAX EXEMPT#
<br /> TOTAL SERnCt/PROAUM 288 . 7500 2x . 38 311 . 13 PRODUCT/SERVICES
<br /> TOTAL CHARGE 331 . 13
<br /> I BERVICE81 TOTAL
<br /> CREDITS 0 . 00 PRODUCT GTY UNIT PRICE TAX CHARGE
<br /> TOTAL DUE 311 . 12 - - d 80887 MODEL 90 1 ,0 241 ,22 21 .71 262,99
<br /> �__�"'➢°�"'� W12307 8 6966
<br /> UNPAID OALANCE THIS RECEIPT 1 311 . 13 'SIN 16029471 TAG 00001170SK15029471 CLEAN 2.5 SPENT O.0
<br /> SERVICE TERM 8 WEEK "• SCANNED NO
<br /> 100090 RECOVERY FEE iA 18,27 1 .19 14.46
<br /> !de clean and goad tonditionY Yes - - - - - - - - - - - - - . _ _ _ � � � � � � - - - - - - — - ^ ^ ^ � � ^ , - - - - - -
<br /> Assembly Condition Yet I
<br /> Is in place and legible'a Yes T03ALSERVICEIPAOOBCTS 26439 22 ,90 27789
<br /> ble link installed? Yes
<br /> ppan . y closing of lid unobstructed? Yes TOTAL CHARGE 277,99
<br /> ine properly grounded' Yes
<br /> 1 Phone No . Sticker Affixed to Machine Yes CREDITS OCO
<br /> t solvent ,beets acceptance crittriaY Yes
<br /> TOTAL DUE 277.99
<br /> MATOR STATUS UNPAID BALANCE THIS RECEIPT 277,99
<br /> :O lb3/month _ _ _ NO ON
<br /> spent e01vea1 meets empim+ oa 0H16r369 Yee
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