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FILE <br /> _-00- Xi 16536-be'iver;,C`o aui p53o, <br /> INVOICE DATE CUST.NO. ORDER NO. PAGE INVOICE NO. <br /> TIRES&SERVICE 07/10/14 194845 32230 1 855-30100 <br /> GCR 350325 STOCKT C855TTC <br /> 4336 POCK LANE, SUITE 200 COPY <br /> STOCKTON, -CA 9.5206 <br /> (209)983-9495 -PAc;q 112 <br /> SOLD SHIP <br /> TO CIRCLE TRANSPORT INC TO ADAM FOR SIERRA CHEMICAL <br /> 315 FIFTH STREET STKN YARD <br /> PERU, IL 61354-2859 CALLED IN BY JUAN <br /> PURCHASE ORDER NO. SALES PERSON PHONE SHIP VIA <br /> Ch at <br /> 4099 209-983-8298 DEL VER <br /> ITEM NO. DESCRIPTION CITY.ORDERED CITY.SHIPPED F.E.T. PRICE NET EXTENSION <br /> 388FTRC BD 11822.5 FCR TRAILER 1 1 121.012 134.61 134.61 <br /> VSTK SV VALVE STEM - TRUCK 1 1 7.Oe 7.00 <br /> AL V2B INFLATE THRU CAP (ALLIGATOR) 1 1 1.512 1.50 <br /> HRTK SV HOURLY RATE - TROCK 1.00 1.00 93.0e 93.00 <br /> TD SCRAP DISPOSAL. CHARGE 1 1 8.02 8.00 <br /> *TRL 125 LIC-TE3508 ID <br /> *RFI LARGE INJURY/IMPACT <br /> *06/27/14 <br /> TPID# 1099876-01 (TDS#) <br /> CNK'D BY: DELVI D <br /> Total Units: 5 <br /> Charge: 244. 11 Sub of Parts: 151. 11 <br /> SubllQt Labor-:- 93,00 <br /> CuM Rav�(JF}�cc�pary�o perform the above written services to their mhlde. <br /> SE I SAE T 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 aro computed on amounts 30 days or more past due at the PERIODIC RATE of 1.5%PER MONTH Inv Total : 244. 11 <br /> (MINIMUM CHARGE OF$1.00)whlch Is an ANNUAL PERCENTAGE RATE OF 18%.The above credlt terms have been set out <br /> in accord with the Truth-In-Lending requirements of the Federal Government and are for the customers benefit and protection. <br /> PAY FROM THIS INVOICE <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 /> A wheel assembly has been installed. Industry <br /> Customer/Fleet Loc# F-7 <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 /> hlubometer 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 it Lic#/State <br /> Trailer If Chassis# Driver Roll Time <br /> Tire/Wheol Pos: (Signature) <br /> Container# Serial/VIN# <br /> (Name Printed) <br /> FILE <br />