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FILE <br /> �� RE�lITf'F(� ` °PO'Bo>�91b5�0,�Den4er,�Q'80291-0530 <br /> INVOICE DATE CUTT,NO. ORDER NO. PAGE INVOKE NO. <br /> TIRES&SERVICE 10/05/1 19494 54114 1 855-50767 <br /> GCR 774346 STOCKT C855TTC <br /> 4336 POCK LANE, SUITE 200 COPY <br /> STOCKTON, CA 95206 <br /> (209)983--9495 Tax Id: Stockton CA 95206 US <br /> Soto CIRCLE TRANSPORTINC SHIP <br /> To CIRCLE TRANSPORT <br /> 315 FIFTH STREET To <br /> PERU, IL 61354-2859 <br /> PURCHASE OROM NO, SALES PERSON PHONE SHIP VIA <br /> C hat h"C,�� <br /> 4099 209--983-8 DELIVER <br /> ITEM NO, DESCRIPTION OTY.ORDERED OW.SMPPED F.E.T. PRICE NET EXTENS" <br /> 388FTRS BD I1R22,5 FCR TRAILER STOCK 1 I 1211-12112 129.7 129.72 <br /> *TRLR 351 LRO TIRE CUT <br /> *TRLR 351 RRO SIDEWALL DAMAGE <br /> *TRLR 125 LRO WORN <br /> *JUAN 209.769.7925 <br /> 388CSA CS 11R22.5 RDL CASING-GRADE A 1 1 0.0115.0 115.00 <br /> 422FTRC BD 111324.5 FCR TRAILER 2 0.0 145.6 291.34 <br /> TRSCO3 TRUCK SERV CALL EMERGENCY REG HOU 1.5 1.50 93.0 139.50 <br /> TRVV01 TRUCK SERV VALVE STEM STEEL 3 3 7.0 21.00 <br /> AL V2B INFLATE THRU CAP (ALLIGATOR) 3 1.5 4.50 <br /> TD SCRAP DISPOSAL CHARGE 2 12.012 24.00 <br /> FS FUEL SURCHARGE-WITH SERVICES ONLY 1 1 10.02 10.00 <br /> TPID# 1099876-0 (TDS#) j <br /> CHKI D BY: I ELVI D <br /> Dtal Uni s: 15 <br /> Charge: 761.21 SubTot Parts: 595.56 <br /> SubTot Labor: 139.50 <br /> n perform the abow written aervkea to they vehicle. Sales Tax: 4b. 10 <br /> SEE INFORMATION STATEMENT OF REVERSE SIDE REGARDING CONSUMER CREDnr CONTRACT AND SECURITY AGREEMENT <br /> X <br /> PRINT NAME/AIrT}tORr2E3 SIGNATURE <br /> NOTE:In order to awe all FINANCE CHARGES,the v w"wr must pry,in full,the entire wwaid balance by the 106 of the following . <br /> month.FINANCE CHARGES are mmputed on amounts 30 days or mere pest due at the PERIODIC RATE of 15%PER MONTH Inv Total 781.21 <br /> (MINIMUM CHARr3E OF$1.00)whkh Is an ANNUAL PERCENTAGE RATE OF 18%,The above aedh berms hew been set out <br /> In aomrd with the Truthanlanding mquiremurts of the Federal Government and are for the customees 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# _Revd 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 1---� <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 Tires <br /> Vehide# Lich/State <br /> Trailer IF Chassis# Driver Roll Time ! <br /> Tire/Wheel Pos: (Signature) <br /> Container# Serial.MN9 <br /> (NamePrinted) <br /> FILE <br />