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FILE 0 <br /> r1ri REMITIT4; PO pox 91053U Dgnvet,t0'8d$�1=0530 <br /> 6ff <br /> ' � I <br /> INVOICE DATE COST.NO. ORDER NO. PAGE INVOICE NO. <br /> TIRES&SERVICE <br /> 05/26/15 194645 40570 1 855-37660 <br /> GCR 350325 STOCKT C855TTC <br /> 4336 POCK LANE, SUITE 200 ecipy <br /> SOLD STOCKTON, CA 95206 SHIP <br /> TO (209)983-9495 1Tax Id: Stockton CA 95206 US <br /> CIRCLE TRANSPORT INC CIRCLE TRANSPORT INC <br /> 315 FIFTH STREET 315 FIFTH STREET <br /> PURCHASE ORDER 10. SALES PERSON PHONE SHIP VIA <br /> ITEM NO. DESCRIPTION QTY.ORDERED CITY.SHIPPED F.E- <br /> T <br /> C <br /> : <br /> PL B NET EXTENSION <br /> 32 4099 209-983-8298 DELIVER <br /> 354FTRS BD LP 22.5 FCR TRAILER STOCK I 1 O.Oe 134.81 134.81 <br /> *TRL# 32 RRO ISIDEWALL CUT] <br /> 354 CS LP 22.5 RDL CASING-GRADE A 1 1 0.0110.0110.00 <br /> VSTK SV VALVE STEM - TRUCK 1 1 7.01Z 7.00 <br /> HRTKE EMERGENCY REG HOURS SERVICE CALL 1.00 1.00 93.093.00 <br /> TD SCRAP DISPOSAL CHARGE 1 1 12.012 12.00 <br /> *LIC# 519685/ILLINOIS <br /> TPID# 1099876-01 (TDS#) <br /> CHK'D BY: DELVI D <br /> Cu;�II,,ppmer euthorius CO- o��rrrr��ggnn the above written services to their vehicle. <br /> SE$1 QI'�1DN STA lgrmVERSE SIDE REGARDING CONSUMER CREDIT CONTRACT AND SECURrrY AGREEMENT SubTot Parts: 263.81 <br /> SubTot Labor: 93.00 <br /> XNet 10th Prox Sales Tax: 23.74 <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 <br /> month.FINANCE CHARGES we computed on amounts 30 days or more past due at the PERIODIC RATE 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 Tnrth-In Lending requirements of the Federal Government and are for the customer's benefit and protection. <br /> PAY FROM THIS INVOICE <br /> T"v TM-ml <br /> PO# <br /> Date Delivered: Disposition of Take Off Tires: 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 <br /> Customer/Fleet Loc# � A wheel assembly has been installed. Industry <br /> guidelines require that the torque level of the <br /> wheel nuts be rechecked between 50 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 Fires <br /> Vehicle# Lic#/State <br /> Trailer# Chassis# Driver Roll Time <br /> Tire/Wheel Pos: (Signature) <br /> Container# SeriaiNlN# <br /> (Name Printed) I <br /> FILE <br />