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Kinsey Central <br /> 6213 HeFat & Air-Conditioning, Inc. <br /> 6 p y� P.O. Box 2209 <br /> ( ! Zephyrhills, Florida 33539-2209 <br /> (813) 782-2300 CA-0058626 <br /> PHONE DATE OFORDE �y <br /> NAME A775 <br /> DATE PROMISED <br /> ADDRESS /� APARTMENT <br /> CITY <br /> MAKE MODEL SERIAL NO. <br /> ❑ ESTIMATE <br /> NATURE OF ❑ CASH <br /> SERVICE <br /> REQUEST ❑ CHARGE <br /> QUAN. PART NO. DESCRIPTION PRICE AMOUNT <br /> I <br /> I <br /> SERVICE PERFORMED TOTAL <br /> MATERIAL <br /> TECHNICAL <br /> SERVICE TIME <br /> A charge of 1.5%will be made on all unpaid balances after 30 days,which is an annual percentage rate TAX <br /> of 18%applied to past due balances.Customer is liable for any charges incurred in collecting this bill. <br /> DATE COMPLETED ON COMPLETION TOTAL <br /> 'lkd�rk CASH OF WORK I <br /> TECHNICIAN CUSTOMER'S SIGNATURE <br />