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FOP SERwCE CALL SERVICE ORDER �
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<br /> GENERATOR WASTE CERTIFICATION(PLEASE CHECK THE APPROPRIATE BOX)
<br /> GENERATOR WASTE CERTIFICATION(PLEASE CHECK THE APPROPRIATE BOX)
<br /> (Waste gill gennrattor/cusgxRY,^MUST check ONE of t^he following three boxedoilgenerator/cusromer MUSTcheck ONE of the following three boxes)
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<br /> rstomer Signature --- -- Date
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<br /> Print
<br /> PIInl Drivels Name - -
<br /> -`fNT1RINSIC c - ^INTRINSIC
<br /> lipTRANSPIORTATION, INC, ' TRANSPORTATION, INC.
<br /> 3250A Dutton Avenue 3250A Dutton Avenue
<br /> Santa Rosa,CA 95407 Santa Rosa,CA 95407
<br /> Phone:(707)57E-0960 Phone:(707)578.0960
<br /> Fax: (707)578-5408 Fax: (707)578 5408
<br /> DATE: '• FREIGHTBILL FREIGHT BILL
<br /> ----�_/_ DATE: L /_ _
<br /> TRUCK x: TRUCK M:
<br /> —MAILER#: !/�-/ _TRAILER M: I
<br /> SUBHAULER: SUBHAULER:
<br /> PRIME CARRIER: / N'/Z/sy S PRIME CARflIER: (_ CUSTOMER:
<br /> ( :
<br /> GENERATOR: ��/'� CUSTOMER - - - GENERATOR: DUMPSITE:_
<br /> LOAD SITE: Dump SITE
<br /> —� LOAD SITE: -
<br /> CITY — CITY: i-.—=/2C CITY: .
<br /> CITY:
<br /> F.O.#: V.O.a:
<br /> SERVICE PERFORMED._ L2 5,( 1� OFFICE USE ONLY SERVICE PERFORMED: OFFICE USE ONLY
<br /> —� TOTAL HOURS, TOTAL HOURS,
<br /> TONS,OR LOADS TONS,OR LOADS
<br /> LOADING DELAYS: RATE S LOADING DELAYS: RATE $
<br /> SUBTOTAL S SUBTOTAL $
<br /> UNLOADING DELAYS: UNLOADING DELAYS:
<br /> MISCELLANEOUS NOTES: /aC/ .- MISCELLANEOUS NOTES:
<br /> AANIFEST#S: --- ------- _-
<br /> ANIFEST#s: ----
<br /> -ALETAG#s: -------
<br /> RILE TAG#S:
<br /> ARr - TOTAL CHARGES j
<br /> S TOTAL CHARGES $
<br /> aFucTwr,s HET 1T P oEw)rnaus
<br /> Nm Receivables.Approval NET
<br /> RfcENtoer R Receivables,Approval
<br /> Payroll Approval RECE1vEoer -
<br /> 111 invoices are due and payable net 30 days.An annual percentage rate of 18%will be prorated monthly on all Payroll Approval
<br /> invoices are due and payable net 30 clays.An annual percentage rate of 18%will be prorated monthly on
<br /> Past due accounts.Costs for collection will be the responsibility of the customer. past due accounts.Costs For collection will be the responsibility of the customer.
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