Laserfiche WebLink
FILE <br /> ,. REMIT TO: PO Box 910530•Denver,CO 80291-0530 <br /> INVOICE DATE CUST.NO, I ORDER NO.I PAGE INVOICE NO. <br /> TIRES&SERVICE 04/20/11 194845 39475 1 855-36654 <br /> GCR 350325 STOCKT C855TTC <br /> 4336 POCK LANE, SUITE 200 <br /> STOCKTON, CA 95206 <br /> (209)983-9495 Tax Id: Stockton CA 95206 US <br /> SOLD CIRCLE TRANSPORT INC SHIP SIERRA CHEMICAL <br /> TO 315 FIFTH STREET TO <br /> PERU, IL 61354-2859 <br /> PURCHASE ORDER NO. SALES PERSON PHONE SHIP VIA <br /> G Il-1 a Y"g t-- i <br /> 445 4099 209-983-8292 DELIVER <br /> ITEM NO. DESCRIPTION CITY.ORDERED CITY.SHIPPED F.E.T. PRICE NET EXTENSION <br /> 422FTRS BD 1iR24.5 FCR TRAILER STOCK. 1 1 0.00 141.94 141.94 <br /> *TRL# 445 RRO [FLAT SPOTTED] <br /> 422 CS 11R24.5 RDL CASING-GRADE A 1 1 0.00 110.00 110.00 <br /> VSTK SV VALVE STEM - TRUCK 1 1 7.23 7.23 <br /> TD SCRAP DISPOSAL CHARGE 1 1 12.00 12.00 <br /> HRTKE EMERGENCY REG HOURS SERVICE CALL 1.00 1.00 93.00 93.00 <br /> TPID# 1099876-0 (TDS#) <br /> CNK'D BY: DELV'D BI: <br /> otal Uni s: 5 <br /> Charge: 388.57 SubT t Parts: 271. 17 <br /> SubT t Labor: 93.00 <br /> Custtuner authonzas company'to perform the above written services to their vehicle. Gales Taxt 24. 40 <br /> SEE INFORMATION STATEMENT OF REVERSE SIDE REGARDING CONSUMER CREDIT CONTRACT AND SECURITY AGREEMENT <br /> X <br /> PRINT NAME/AUTHORIZED SIGNATURE <br /> NOTE: In order to save all FINANCE CHARGES,the customer must pay,in full,the entire unpaid balance by the 10th of the following Inv Total 388.57 <br /> month.FINANCE CHARGES are computed on amounts 30 days or more past due at the PERIODIC PATE of 1.5%PER MONTH <br /> (MINIMUM CHARGE OF$1.00)which is an ANNUAL PERCENTAGE RATE OF 18%.The above credit terms have been set out <br /> in accord with the Truth-In-Lending roquiremonts of the Federal Government and are for the customer's benefit and protection. <br /> PAY FROM THIS INVOICE <br /> PO# <br /> Date Delivered: Disposition of Take Off Tires: O Your wheel components have been inspected <br /> Fleet Authorization # _Ret'd w/Driver _Ret'd w/Dealer and it has been determined your wheel components <br /> Credit Release# _Ret'd to Customer —Ret'd for Warranty require immediate attention. <br /> Phone: <br /> Customer/Fleet Acct# Tire Replacement Reason I--� A wheel assembly has been installed. Industry <br /> Customer/Fleet Loc# I—J <br /> guidelines require that the torque level of the <br /> wheel nuts be rechecked between SO and 100 <br /> Vehicle Information: For ERS Information Only: miles of operation and retorqued as necessary. <br /> Hubometer ERS Work Order# Failure to do so may result in loss of this assembly. <br /> Make Odometer DOT On Tires I acknowledge receipt of wheel assembly info. <br /> Model Color DOT Off Tires <br /> Vehicle# Lic#/State <br /> Trailer# Chassis# Driver Roll Time <br /> Tire/Wheel Pos: (Signature) <br /> Container# Serial/VIN# <br /> (Name Printed) <br /> FILE <br />