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ECO-CHEK Compliance, Inc. <br /> ece P.O. Box 1394, Lafayette, CA 94549 <br /> P:888-500-CHEK F:415-399-9602 E: contact@ecochek.com <br /> www.ecochek.com <br /> EGO-CHEK COMPLIANCE INC <br /> WORK ORDER <br /> P.O. # <br /> Service Tech#1 CY <br /> Service Tech#2 <br /> Service Tech#3 <br /> Site-( r j ` a'- C.� <br /> JCq O L <br /> 1 >. C'V�o n Date of Service I 12.b <br /> �✓ <br /> Phone# <br /> X Technician Signature <br /> Work Authorization(customer signature) <br /> Service Requested <br /> Product Code <br /> Start Time: End Time: Component: Action: <br /> Description of work performed: <br /> `O 0112 <br /> c <br /> Parts Used(part#) Description QTY Old SN New SN <br /> Additional Work Needed? <br /> Describe: (only if job not complete) <br /> Parts Needed(part#) Description <br /> QTY Price ea. <br /> Must Return Multiple Techs Regular Labor $ <br /> omplete 1st Tri After-Hours Dispatch Overtime Labor $ <br /> tern ete Double Time Labor $ <br /> Travel Hours $ <br /> Please note: Minimum one hour Labor and Minimum one hour Travel will be billed, Mileage <br /> after an hour -time will be rounded up to the full hour Materials <br /> Sales Tax% <br /> X X Total <br /> Total due in 15 days, upon receipt. Overdue accounts subject to a service charge of 5% per month. <br />