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Fr <br /> 1ral) <br /> Date <br /> - If returned unpaid,I authorize my account <br /> e/DseEQUf�/{.r to be debited electronically for both the -. <br /> u///j09/17/-093/ check amount and return check tees. <br /> 4 State canfragor Uc.839647 P.O. BOX 8067 DL# <br /> /Ir79/9/5-60/0 <br /> SSOLD TO: Stockton, CA 95208 sign. <br /> . <br /> o'L JOB ADDRESS: <br /> N �G7�L l AL NNAE <br /> STATE nP crry <br /> STATE DP <br /> HOME PHONE WORK PHONE <br /> o <br /> EMERGENCY WAIVER OF RIGHT TO CANCEL XruHeER HOME PHONE <br /> WORK PHONE <br /> ESTIMATE AND PROPOSAL - Authorized Signature <br /> WE PROPOSE THE FOLLOWING: (Estimate and Proposal does not include unforseen circumstances) <br /> CHANGE <br /> PRICE CUSTOMER APPROVAL <br /> NOTES AND COMMENTS: <br /> O CASH ❑CHECK OCG. ❑CHARGE APP VD By <br /> CREDRCARONO CHARGE <br /> EXPIRATION DATE <br /> AWHORIIATION CODE DRNER'S LIC NO. ADO'L CHARGE <br /> EXP GATE ACCOUNT NO ws.oura <br /> K„VYe N I <br /> WORK AUTHORIZATION PAYMENT OF THIS INVOICE/ MISC. CHARGE <br /> CONTRACT DUE UPON COMPLETION OF WORK <br /> authorized representativeltenant of AUTHORIZATION TO PROCEED WITH PROPOSED WORK. I, the undersigned, am owner/ SUB TOTAL <br /> done. I hereby authorize you to perform said work, and t remises at huse such labore worktioned and materials asoybe <br /> ou <br /> deem advisable.A monthly service charge of 1 1/2% will be added after 30 days. I agree 10 pay TAX <br /> reasonable attorney's fees and court costs in the event of legal action or reasonable bank costs <br /> if my check fails to clear. I have read, agree to, and have received a copy of the contract. TOTAL <br /> I hereby authorize you to proceed with the above w p $ Jlrti . orr', <br /> Plus any additional Costs resulting from any than es the price of �_ r`oro�oz &ta r <br /> WORK ORDER, PRICEAND CUSTIJMEA APPgg not dd In the U�gryGES TO end materials rerNCE OidFe ed RK PERFORMED <br /> E FORMEalled in rnn find <br /> naCo�service <br /> R�VAL"section above. <br /> AUTHORIZED / ^.- / above work mentioned,to have With the <br /> SIGNATURE X ' factory manner. 1 agree that the n con,pletedIn on ih5 <br /> ( � contract In the space labeled 'TOTAL' tD he the <br /> do hereby state that the above work haSbeen installed in a workmanlike manner and to that have read and race ved a legible total end <br /> 1e applicable building codes. con plate charge.1 agree to pay reasonable act, attomey's fees <br /> end churl costs in the event of legal action. 1 ackr owted e <br /> r _ and have reed the Notice to Owner end statement ventrad <br /> on contract on reverse side. requirad <br /> vice TOChnlCian Signarure �,'a-' V <br /> A ACCEPTANCE SIGNATURE — <br /> REORDER X2A)323.9868 <br />