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FILE <br /> C, 9EMIT T0: . Po Box 910530•Denvbr,CO 60291 0530 <br /> 6 rinfIR <br /> INVOICE DATE I COST.NO. I ORDER NO.I PAGE INVOICE NO. <br /> TIRES&SERVICE 11/30/1 194845 55950 1 1 855-52289 <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 /> SO1-D CIRCLE TRANSPORT INC SHIP CIRCLE TRANSPORT INC <br /> TO 315 FIFTH STREET TO 315 FIFTH STREET <br /> PERU, IL 61:54-2859 STOCKTON, CA 95206 <br /> PURCHASE ORDER NO. SALES PERSON PHONE SNIP VIA CM <br /> 4099 209-983-82 DELIVER <br /> nEM NO. DESQCPTION QTY,ORDERED QTY.SHIPPED F.E.T. PRICE NET WENMON <br /> *WO:85513750 LN:001; 004 <br /> 388B76C 111122.5 B760 2 2 0.00 200.65 461.30 <br /> *TRK# 329 RRI RRO [WORN] <br /> TRSC03 TRUCK SERV CALL EMERGENCY REG HOUR3 1.75 1.75 97.00 169.75 <br /> FS FUEL SURCHARGE-WITH SERVICES ONLY 1 1 10.00 10.00 <br /> TRVV01 TRUCK SERV VALVE STEM STEEL 22 7.00 14.00 <br /> AL V2B INFLATE THRU CAP (ALLIGATOR) 2 2 1.53.00 <br /> i <br /> I <br /> TPID# 1099876-01 (TDS#) <br /> CHK'D BY: DELVTD <br /> Total Units: 9 <br /> Charge: 626.67 Sub t Parts: 428.30 <br /> Sub t Labor: 169.75 <br /> Customer wtlswbws company m the ebv+e written tervlces to their VeNde. , <br /> SEE INFORMATION STA OF REVERSE SIDE REGARDING CONSUMER CREDIT CONTRACT AND SECURITY AGREEMENT <br /> X PRINT NAME/AUTHORIZED SIGNATURE <br /> NOTE In order to a"all FINANCE CHARGES.the c tomer must M.in fug,the entire unpaid beLtnce by the 101h of the following Inv Total 626.67 <br /> month.FINANCE CHARGES are computed on amounts 30 days or mare pest due at the PERIODIC RATE of 1.5%PER MONTH <br /> (MINIMUM CHARGE OF$1.00)vthleh is an ANNUAL PERCENTAGE RATE OF 16%The above aedirt temu have been set out <br /> In accord with the TMh4n-Lend0ng reWlrements of the Federal Gowmment and are for the customer's benefit and Prot.ctlon- <br /> PAY FROM THIS INVOICE <br /> Poll <br /> Date Delivered: Disposition of Take Off Tires: O 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 requlre immediate attention. <br /> Phone: <br /> Customer/Fleet Acct# Tire Replacement Reason �--1 A wheel assembly has been installed. Industry <br /> Customer/Fleet Loc# J 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# Llc#/State <br /> Trailer# Chassis# Driver Roll Time (Signature) <br /> Tire/Wheel Pos: <br /> Container# SerialMN# <br /> ( ame Prime ) <br /> FILE <br />