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SERVICE/REPAIR AUTHORIZATION <br /> STOCWrON ATM E SERVICE <br /> f COM <br /> CALIFORNIA CONTRACTOR LICENSE M105 CEI.SA <br /> !0!-11M N.UNION ST.STOCKTON.CALIF.9520P.0 <br /> .BOX SOB STOCKTON,CALIF.NMI <br /> PHONE 30B/BBF-9533 <br /> SALES • SERVICE • INSTALLATION OF PETROLEUM DISPENSING • LUBRICATION A INDUSTRIAL SERVICE EQUIPMENT <br /> P.O.11 DATE <br /> � _ <br /> - <br /> AUTHORIZING NAME COMPANY NAME <br /> 1 <br /> BUSINESS ADDRESS ST. <br /> LOCATION <br /> CITY ZIP PHONE <br /> AUTHORIZED REPAIR OF THE FOLLOWING EOUIPMENT <br /> { <br /> I HEREBY AUTHORIZETHE REPAIR/SERVICE WORK TO BE DONE BY STOCKTON SERVICE STATION EQUIPMENT COMPANY <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.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 /> 1 AGREE TO BE INVOICED ANP WILL BE SUBJECT TO TERMS. <br /> AUTHORIZ SIGNATURE TITLE <br /> FORM IS 0016 <br /> CUSTOMER COPY <br />