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<br />KINSEY CENTRAL
<br />HEAT & AIR-CONDITIONING
<br />P.O. Box 2209
<br />7718 Fort King Highway
<br />ZEPHYRHILLS, FL 33539.2209
<br />(813) 782-2300
<br />
<br />BILL TO
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<br />STRE,r ~ 1 q . <; a u..,-I/ A tJ .Eo
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<br />CIT'I" I I ,
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<br />PH<:J ~ &.. 70 1/.3
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<br />CALL BEFORE
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<br />TECHNICIAN
<br />
<br />AUTHORIZED BY
<br />
<br />WORK TO BE PERFORMED
<br />
<br />QTY.
<br />
<br />MATERIAl.58. SERVICES
<br />
<br />UNIT PRICE
<br />
<br />:
<br />
<br />REFRIGERANT R.
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<br />LBS.
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<br />TOTAL MATERIALS
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<br />LABOR
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<br />RATE
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<br />MATERIALS & LABOR MAY BE:
<br />CONTINUED ON OTHER SIDE
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<br />TERMS
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<br />()
<br />DATE
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<br />PROMISED
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<br />REPL. START
<br />RELAY
<br />REPL. START
<br />CAPACITOR
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<br />HVAC
<br />SERVICE ORDER
<br />INVOICE
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<br />THIS WORK IS TO BE
<br />
<br />o C.O.D.
<br />
<br />MAKE
<br />
<br />MODEL
<br />
<br />SERIAL NUMBER
<br />
<br />ENVIRONMENTAL CHECK LIST
<br />. .
<br />
<br />WOF\K PEF\FORMED OTY.
<br />D RECOVERED
<br />[1 RECYCLED
<br />r I RECLAIMED
<br />[] RETURNED
<br />r-I DISPOSAL
<br />LJ DISMANTLELJ
<br />1:1 CHANGED OUT/REPLACED TOTAL $
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<br />TYPE/DISPOSITIQN
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<br />
<br />DESCRIPTION OF WORK PERFORMED
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<br />RECOMMENDATIONS
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<br />o CHARGE
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<br />MAKE
<br />
<br />MODEL
<br />
<br />SERIAL NUMBER
<br />
<br />1.:)44
<br />
<br />[J NO CHARGE
<br />
<br />CONDENSING UNIT
<br />
<br />WORK PERFORMED
<br />
<br />COND'SATE DRAINS
<br />
<br />LEVELED
<br />
<br />CLEANED COil
<br />CHECKED
<br />CHARGE
<br />I=tEPAIRED
<br />LEAK IN COIL
<br />REPAIRED
<br />LEAK IN COPPER
<br />.---.---
<br />
<br />1/ HEf
<br />
<br />CHECKED
<br />MOTOR
<br />CHANGED
<br />MOTOR
<br />REPLACED
<br />BELT
<br />
<br />HE PLACED FUSE
<br />
<br />I~EPLACED
<br />COMPRESSOR
<br />EVAPORATOR COIL
<br />
<br />liEPLACED
<br />EXP. VALVE
<br />
<br />,),OJUSTED
<br />EXP. VALVE
<br />
<br />11EPLACED
<br />CAP. TUBE
<br />
<br />CLEARED
<br />CAP. TUBE
<br />
<br />liEPAIAED
<br />COil lEAK
<br />
<br />FIEPA1RED
<br />COPPER CONN
<br />
<br />CLEANED COIL
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<br />"7' ((J' (J LEVELED COIL
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<br />- ... ......." r. . . ELECT. HTR.
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<br />LIMITED WARRANTY: All materials, parts
<br />and equipment are warranted by the
<br />manufacturers' or suppliers' written warranty
<br />only. All labor performed by the above named
<br />company is warranted for 30 days or as
<br />otherwise indicated in writing. The above named
<br />company makes no other warranties, express
<br />or implied, and its agents or technicians are
<br />not authorized to make any such warranties
<br />on behalf of above named company.
<br />
<br />I have authority to order the work outlined above which has been satisfactorily completed. I agree thai
<br />Seller retains title to equipment/materials furnished until final payment is made. If payment is not made
<br />as agreed. seller can remove said equipment/materials at Seller's expense. Any damage resulting from
<br />said removal shall not be the responsibility 01 Seller.
<br />
<br />CUSTOMER SIGNATURE
<br />
<br />DATE
<br />
<br />[] REGULAR
<br />LJ SERVICE CONTRACT
<br />
<br />LJ WARRANTY
<br />
<br />9"U qjff<<;
<br />
<br />HEPAIHi::D WIRE
<br />
<br />f~EPLACED CONT
<br />
<br />FILTERS
<br />
<br />TOTAL
<br />MATERIALS
<br />TOTAL
<br />LABOR
<br />
<br />TRAVEL
<br />CHARGE
<br />TAX
<br />
<br />TOTAL
<br />
<br />I I
<br />
<br />CLEANED
<br />MAIN DRAIN
<br />REPAIRED
<br />MAIN DRAIN
<br />CLEANED
<br />PAN DRAIN
<br />
<br />-
<br />
<br />REPAIAED
<br />PAN DRAIN
<br />
<br />----
<br />FURN. OR FAN COIL
<br />_~ __.~_u_~___ .~_u
<br />
<br />REI-'L ACI::O I.:3H r
<br />
<br />AOJUSI ED BEL'
<br />
<br />REPLACED
<br />PULLEY
<br />ADJUSTED
<br />PULLEY
<br />CLEANED
<br />BLOWER
<br />REPLACED
<br />BEAAINGS
<br />
<br />OILED M01QR
<br />
<br />OILED BEARINGS
<br />
<br />CLEANED
<br />HEAT EXCH
<br />
<br />REPLACED
<br />HEAT EXCH
<br />
<br />CLEANED OR
<br />ADJ_ PILOT
<br />
<br />REPLACED
<br />THERMOCOUPLE
<br />
<br />REPAIRED
<br />VALVE
<br />
<br />REPLACED
<br />VALVE
<br />
<br />CLEANED
<br />BURNERS
<br />
<br />DUCT
<br />
<br />REPAIRED
<br />
<br />ADJUSTED
<br />
<br />THERMOSTAT
<br />-f------- -
<br />HEPLACED
<br />
<br />ADJUSTED
<br />
<br />CLG TOWER
<br />
<br />CLEANED
<br />
<br />_ ___. ._.__L.
<br />
<br />PUMP(S)
<br />
<br />GREASED
<br />
<br />REPAIRED
<br />
<br />i Cl_EANl:D
<br />
<br />i J REPLACED
<br />
<br />TOTAL SUMMARY
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