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• r �v�— <br /> Customer Name fq Date: <br /> � . � OR Accounk 1� , _ <br /> Address: Te . , ��o� <br /> ti� <br /> 35946 SR 54 Zephyrhills, FL 33541 , �� S Job Name: � ` <br /> � Address: <br /> Phone: Cell: <br /> 813.870.6934 • FaX 813.783.2336 Home: <br /> License No. CAC1814196 RESIDENTIAL Email: Phone: <br /> Home: Cell: <br /> Reason for call: bescription of work performed: <br /> ` � r \ <br /> \� �.. <br /> Time Dispatched Arrival Time Time Completed <br /> Type Age: Type Age: Technicien commendations: <br /> Brand: Brand• <br /> Model: Model: � <br /> Serial No.: Serial No.: WANT TO PAY LESS? <br /> Filter sizes and Proper Filters Yes/No • ' SERVICE AGREEMENT CWSTOMER'S PAY LESS! <br /> QTY REPAIR CODE DESCRIPTION PRICE This service agreement has been explained to me and I decline to participate <br /> REG SMA <br /> $ $ � SAVINGS $ DECLINE INITIALS ACCEPT INITIALS <br /> r $ $ � PAID BY: CASH � CHECK ❑ <br /> SUBTOTAL $ <br /> $ '� CREDIT CARD ❑ # <br /> $ $ OTHER $ <br /> CARD# <br /> $ $ TOTAL $ <br /> TYPE: EXPD DATE: <br /> $ $ <br /> �, NAME ON CARD: <br /> " � $ $ <br /> ADDRESS FOR CARD: <br /> $ $ <br /> $ $ ��a�T�! Warranty: <br /> All of us at All- ech Air, Inc. Parts: <br /> $ $ lue this opportunity to serve you! Labor: <br /> � � � f <br /> TOTAL REPAIRS: X X <br /> $ $ <br /> � FvLt:c.C;i?E71dlU�. <br /> � <br />