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SERVICE/REPAIR AUTHORIZATION <br /> AT10N EOUIEPRIMENT CO,INC. <br /> CALIFORNIA CONTRACTOR LICENSE MlM C41,SA <br /> MIBBA N UNION ST.STOCKTON,CALIF.95205 <br /> P.O.BOK SOS STOCKTON.CALIF.116201 <br /> PHONE 205/� <br /> SALES • SERVICE • INSTALLATIONOFPETROLEUMDISPENSING • LUBRICATIONAINOUSTRULLSERVICEEOUIPMENT <br /> DATE, <br /> P.O.It <br /> j % <br /> AUTHORIZING NAME COMPANY NAME <br /> UI LL <br /> BUSINESS ADDRESS ST. <br /> LOCATION <br /> CITY ZIP PHONE <br /> mv5tJ} <br /> 1 <br /> r <br /> AUTHORIZED REPAIR OF THE FOLLOWING EQUIPMENT <br /> V 1� <br /> vv� <br /> w-vi 1 <br /> � I. <br /> c Iv 4- <br /> HEREBY <br /> HEREBY AUTHORIZE THE REPAIR/SERVICEWORKTO BE DONE BY STOCKTON SERVICE STATION ECUIPMENTCOMPANY ' <br /> INC.AS DESCRIBED ABOVE ON THE EQUIPMENT NAMED HEREON.ALL REPAIR PARTS ARE TO BE BILLED AT S.S.S.E. <br /> REGULAR PRICES.I AGREE TO PAY CASH FOR SUCH REPAIR PARTS AND LABOR ON DELIVERY OF EQUIPMENT OR ON <br /> TERMS SATISFACTORY TO S.S.S.E.AND UNTIL PAID IN FULL ANY UNPAID BALANCES SHALL CONSTITUTE A LIEN ON THIS <br /> EQUIPMENT. 1 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 WILIfIE SUBJECT TO TERMS. <br /> AUTHORIZED SIdINATURE TITLE <br /> X G✓/��' SC�� fV( �a <br /> FORM N 0015 CUSTOMER COPY <br />