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,,QUIN COUNTY <br /> NMENTAL HEALTH DEPARTM`kIT Page 2 <br /> ;MAIN STREET <br /> -;KTON, CA 95202 <br /> ' ane: (209)468-3420 <br /> INVOICE AccountlD AR0029006 <br /> FacilityID FA0016482 <br /> Date Printed 4/25/2007 <br /> FETTERS,ALLAN RE : RIPON FARM SERVICE <br /> RIPON FARM SERVICE 932 S HWY 99 E FR RD <br /> 3705 PORTSMOUTH CIRCLE RIPON, CA 95366 <br /> STOCKTON, CA 95219 <br /> OWNER : RIPON FARM SERVICES <br /> Date Health <br /> Program Description <br /> Amount <br /> Total forthis Invoice $ 104.50 <br /> Payment Due Date 4/26/2007 <br /> Invoice# IN0161406---Date of Invoice: 4/23/2007 I IIIIIII IIIIII III VIII VIII VIII VIII VIII VIII IIIII IIIII IIIII IIII IIIIII IIIII IIII IIII <br /> Hrs Employee <br /> 3/1/2007 2960 312-CONSULTATION 0.30 MCCARTNEY $ 28.50 <br /> 3/6/2007 2960 312-CONSULTATION 0.70 MCCARTNEY $ 66.50 <br /> 3/13/2007 2960 312-CONSULTATION 0.20 MCCARTNEY $ 19.00 <br /> Total for this Invoice s 114.00 <br /> Payment Due Date 5/25/2007 <br /> TOTAL DUE this Billing Period $ 1,719.50 <br /> Please make Checks PAYABLE to: 'EHD' — Return a Copy of This STATEMENT with Your PAYMENT <br /> Penalties will be added to all Permit Fees For OES/HMMP Fees For all SERVICE FEES <br /> at the Rate of 100%of the Base Fee Penalties will be added at the Rate of 10% Penalties will be added at the Rate of 10% <br /> 30 Days after the Due Date 45 Days after the Invoice Date 60 Days after the Invoice Date and each 30 Days thereafter <br /> i254.rpt <br />