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FILE <br /> 1/ <br /> CREMITTO: $0- PO Box 910530•benver,CO 80291-0530 <br /> INVOICE DATE CUST.NO. ORDER NO. PAGE INVOICE NO. <br /> TIRES& SERVICE <br /> 07/31/1 194845 42746 1 1 1 855-39658 <br /> OCR 350325 STOCKT C855TTC <br /> 4336 POCK LANE, SUITE 200 <br /> STOCKTON, CA 95206 <br /> (209)983-9495 lax No gtnu-ktnn CA q9PPIA 1151 <br /> sow SHIP <br /> TO CIRCLE TRANSPORT INC TO CIRCLE TRANSPORT INC <br /> 315 FIFTH STREET 315 FIFTH STREET <br /> PERU, IL 61354-2859 PERU, IL 61354-2859 <br /> PURCHASE ORDER NO. SALES PERSON PHONE SHIP VIA <br /> CI-r ar g e <br /> 4099 209-983-8298 DELIVER <br /> ITEM NO. DESCRIPTION QTY.ORDERED CITY.SHIPPED F.E.T. PRICE NET EXTENSION <br /> 388FTRS BD 1IR22.5 FGR TRAILER STOCK 1 1 0.00 134.81 134.81 <br /> 388 CS 1iR22.5 RAL CASING-GRADE A 1 1 0.00 110.00 110.00 <br /> HRTKE EMERGENCY REG HOURS SERVICE CALL 1.00 1.00 93.00 93.00 <br /> TD SCRAP DISPOSAL CHARGE 1 1 12.00 12.00 <br /> VSTK SV VALVE STEM - TRUCK 1 1 7.00 7.00 <br /> *TRL# 125 LRI [RUN FLAT] <br /> *LIC# 525298/ILLINOIS <br /> TPID# 1099876-01 (TDS#) <br /> CHK'D BY: DELVI D <br /> Total Units: 5 <br /> Charge: 380.55 Sub at Parts: 263.81 <br /> Sub t Labor: 93.00 <br /> Cu {�j au/f� o perform the above written services to their vehicle. Sales Tax: 23.74 <br /> SEFORMMN 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 <br /> ' month.FINANCE CHARGES are computed on amounts 30 days or more past due at the PERIODIC RATE of 1.5%PER MONTH I n V Total 380■S5 <br /> (MINIMUM CHARGE OF 51.00}which is an ANNUAL PERCENTAGE RATE OF 18%.The above credit terms have been set out <br /> in accord with the Truth-In-Lending requirements 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# _Reed w/Driver _Reed w/Dealer and it has been determined your wheel components <br /> Credit Release It __,Reed to Customer _Reed for Warranty require immediate attention. <br /> Phone: <br /> Customer/Fleet Acct# Tire Replacement Reason A wheel assembly has been installed. Industry <br /> Customer/Fleet Loc# 0 <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 Tires <br /> Vehicle# Lic#/State <br /> Trailer# Chassis# Driver Roll Time <br /> Tire/Wheel Pos: (Signature) <br /> Container# SerialNlN# <br /> (Name Printed) <br /> FILE <br />