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- Kinsey Central <br /> Heat & Air-Conditioning, Inc. <br /> P.O. Box 2209 <br /> Zephyrhills, Florida 33539-2209 <br /> (813) 782-2300 CA-0058626 <br /> PH - DATE OF ORDER <br /> NAME DATE PROMISED <br /> J <br /> ADDRESS �• © APARTMENT <br /> CITY S. <br /> MAKE MODEL SERIAL NO. <br /> ❑ ESTIMATE <br /> NATURE OF ❑ CASH <br /> SERVICE ❑ CHARGE <br /> REQUEST <br /> QUAN. PART NO. DESCRIPTION PRICE AMOUNT <br /> I <br /> o�- <br /> I <br /> I iffy: <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 s liable for any charges incurred in collecting this till. <br /> DATE COMPLETED ON COMPLETION y TOTAL <br /> CASH OF WORK <br /> TECHNICIAN CUSTOMER'S SIGNATURE <br />