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�. 7 3887 N.Valentine Ave.* Fresno,CA 93722 *(559)444-1730 k::::] 13lllable <br /> f t v - M Factory Warr. <br /> tij.IFs License No.779267 * AN EMPLOYEE OWNED COMPANY f= COD <br /> Please Vlslt Our Webslte: www.lcsofvlcos.com <br /> F,rROGL F�I CANANc CU, C::] Not Billable <br /> C:] Bid Job <br /> tit <br /> Name:_ N° 1 796 <br /> Service 2qo 3 (/Z <br /> Address'.— <br /> city:- <br /> ddress:City: Zip: P11on©: Work Order N 2 r 9 22 <br /> Dispenser Make Cult,P.ou <br /> Dispenser Model: Close Conlir.n <br /> Dispenser Serial #: PurchaieOrderk <br /> Pump Test: Gallons: DollarAnit: <br /> Description of Work Performed <br /> ¢� V dr -ep4ek ?aAe— ..cam t I FC— <br /> fir- <br /> give authorization to LC Services <br /> Signature & Date Print Name <br /> to run my credit card as form of payment. <br /> the N>e kr a$7 w boo" ,ng� fee I mVw a="u uw;wd to a M P"fa CDMCWs.SMW sal 0o w—wKed <br /> retx aryxermsa <br /> arbe. amerigvmWara01n—nabaaw%ygtee:andm.coIjwtorprWw, Card 0: <br /> sal u n lria�1 a Fnsn ewtir Nwe>�vp+o too a any a�q�h^pK b ferny dnPbY^KM a nn a tredi repaf p <br /> �m>wnaa7ary fc kiN myar r.�oe galon a ma a Card Type: Bwing Zip: <br /> r_anm�ar"aax v'vane K rreassy ore gran oemussaT b yaa ofim,a ya.assgry,b mrxad rnlJ.a 6Y mare r Yra se <br /> un&tape IMSft�mgdrn:,MM*ane=pemay be*ft pommaftweww*ft n,rn,e. Exp Dater/^1 3 Digit Security Code: <br /> Lftw omaw.e vm*q try nn me maer CLC Semon)N%reby.mrnsy tlatlaM at x anw&miner erprtsweda rVed,rbibaq Name on Card: <br /> any myeC.aI of inerC&�d f4en b a pw4w[�R/Po alb ndmer am--$nor ae—airy ods paws b awame <br /> rvtrykt*� rmwectarIII mes*ofsWprodictt Work Authorized by Date <br /> Signature <br /> A 3%CO NVE N I ENCE FEE WILL 8E APPLIED TO ALL CREDIT CARD TRANSACTIONS <br /> Qty Part No. Inv. Description & SIN Each Amount <br /> Loc# <br /> Worker Pate trepan EArriveDepartStop O/T <br /> Total Labor <br /> Total Parts <br /> Mileage <br /> Travel <br /> t�night <br /> Sales`tax <br /> Totai Amount <br />