Laserfiche WebLink
p SERVICE/REPAIR AUTHORIZATION <br /> f QS�f OO GAJ L©��i1LG�14�0��� <br /> E. CALIFORNIA CONTRACTOR LICENSE 009105 C-61,SA <br /> f W9-020 N.UNION ST.STOCKTON,CALIF.95205 <br /> P.O.BOX 509 STOCKTON,CALIF.95301 <br /> 1 PHONE 309/4M-B333 <br /> (€ SALES SERVICE INSTALLATION OF PETROLEUM DISPENSING LUBRICATION&INDUSTRIAL SERVICE EQUIPMENT <br /> DATE <br /> {{CF P.O.# <br /> AUTHORIZING NAME COMPANY NAME <br /> BUSINESS <br /> ADDRESS ST. <br /> q <br /> LOCATION �j ) U <br /> n CITY ZIP PHONE <br /> I <br /> 4[ <br /> AqTWPED REPAIR OF THE FOLLOWMG EQUIPMENT <br /> i <br /> C <br /> i <br /> {{l 1 <br /> 4 y PAIRARE TO S S.S.E. <br /> cnaA FOR Gh nvYAIR PARTS AND LABOR ONON DELIVERY OFF EQUIPMENT OR ON <br /> TERMS SATISFACTORY TO S.S.S.E.AND UNTIL PAID IN FULL ANY UNPAID BALANCES SHALL CONSTITUTE AUEN ON THIS <br /> SU <br /> EQUIPMENT. I FURTHER AGREE THAT S.S.S.E.WILL NOT BE HELD RESPONSIBLE FOR LOSS OR DAMAGE TO SAID <br /> EQUIPMENT FROM FIRE,THEFT OR OTHER CAUSES BEYOND S.S.S.E'S CONTROL. <br /> I AGREE TO BE INVOICED AND WILL BE SUBJECT TO TERMS. <br /> TITLE <br /> FORM 110015 <br /> CUSTOMER COPY <br /> • �)WVICE9P'_9RK TO Be OONEBT'STOCKTON SFPVICE_STATII--QUIPMENT C- '• <br /> 9�F _ QUIPMFI�T NAMED HEREON.AI' ` =BIL'F^ <br />