Laserfiche WebLink
NCA-i <br /> ^ Modesto Bottled Water Inc <br /> NO 3ox 4643 <br /> Modesto CA 95352 Account <br /> (209)527-6764 <br /> Charge Code <br /> f ►� 16 736 <br /> Serv,ce Address pate A Ir OJ <br /> G�--��v�'ri SQA Phore No <br /> �p<4- ' <br /> (o c/ <br /> t; r 1 }ay Route No ~ ?U <br /> ZIP— )-- - 7 Equipment Type Ta L.., <br /> Bdl,ngAddress _C2-Lt7. SersalNor' <br /> 13Renta!S 9, 01:�, der, 2,,, 4, — <br /> 1'4 —zip Reference fI <br /> 1 <br /> Nome Office Phone 1 Ref Phone <br /> Owner/Ernpbyer Phone <br /> Nome/Employer Address Zip <br /> S S# Bus,ness/Coers L,c No <br /> fes;.N0N[AXML,E�� /�s;moi Ct�D1= "Q� ��NIT PRiC �"AMU�1 <br /> rO.PsFr'f •a 3'i y_,< -��%riY�<.,•u" :�,vry i /,� • i' %f <br /> TAXABLE SALES <br /> Cups 42R 450 Sty- <br /> soTTLE DEPOS)TS CM <br /> Z / <br /> aotoes �� <br /> m Nand rte[utned Sales-Tax <br /> TOTAL 3� C,) <br /> EQUIP NO ISED ill <br /> ReCmed Deck Cam I I <br /> on Accu t Z (o j - <br /> HIMKI Equipment tease <br /> I am theTte <br /> a [Y,e Customer Agreement Accepted initial I <br /> to accs t agreement and <br /> haverech d,terns AccdptPd'M desto Bottled-Water. Inc <br /> 1 <br /> BY <br /> S,gn ett r By I <br /> Title lhn[Nage Darelnstafted <br /> .rrr f}rFIrFu4ilit CLWOMERYELY)W <br /> nCCt7+NC rgr+u( <br /> nRfvlrn rmn w 7i it <br />