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SERVICE/REPAIR AUTHORIZATION <br /> I <br /> - �1n1U UOl1V 15����'�J11�U�;1 l� �Oa9oll�.l�7a . <br /> CALIFORNIA CONTRACTOR LICENSE 309105 A-C61/D40 HAZ <br /> 808 N.UNION ST.STOCKTON,CALIF.95205 <br /> P.O.BOX 508 STOCKTON,CALIF.95201 <br /> 1 PHONE 209/464-8333 <br /> f <br /> SALES SERVICE INSTALLATION OF PETROLEUM DISPENSING LUBRICATION h INDUSTRIAL SERVICE EQUIPMENT <br /> DATE <br /> P.O.# 4 <br /> AUTHORIZING NAME COMPANY NAME <br /> I <br /> I <br /> BUSINESS ADDRESS ST. <br /> LOCATION <br /> s CITY ZIP PHONE <br /> y AUTHORIZED REPAIR OF THE FOLLOWING EQUIPMENT <br /> F <br /> m <br /> o f <br /> m12 05 1) 11 - 7 ! , ' <br /> =J m w a <br /> N W <br /> 5.8 ®7C <br /> V <br /> r <br /> 2 U g s <br /> L <br /> I <br /> i 0 m [V zo 7 - <br /> A /� F1 X141 <br /> - ` <br /> r°, <br /> HEREBY AUTHORIZE THE REPAIR/SERVICE WORK TO BE DONE BY STOCKTON SERVICE STAT;lpN EQUIPMENT COMPANY <br /> INC.AS DESCRIBED ABOVE ON THE EQUIPMENT NAMED HEREON.ALL REPAIR PARTS AR TO BE BILLED AT S.S.S.E, <br /> REGULAR PRICES.I AGREE TO PAY CASH FOR SUCH REPAIR PARTS AND LABOR ON DEU4ERY OF EQUIPMENT OR ON <br /> TERMS SATISFACTORY TO S.S.S.E.AND UNTIL PAID IN FULL ANY UNPAIDBALANCES 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. i <br /> I AGREEITO BE INVOICED AND WILL BE SUBJECT TO TERMS. <br /> f, AUTHORIZED SIGNATURE <br /> (� TITLE <br /> ! X Y/ �� �l l l`-1..Y �+J'a ,P IN .111 <br /> FORM 1110015 CUSTOMER COPY <br />