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<br />Kinsey Central <br />Heat & Air-Conditioning, Inc. <br />P.O. Box 2209 <br />Zephyrhills, Florida 33539-2209 <br />(8,13) 782-2300 <br />; <br /> <br />RA0056288 <br /> <br />NAM <br /> <br /> <br />I PHONE <br /> <br />DATE OF ORDER <br /> <br />DATE PROMISED <br /> <br />ADDRESS <br /> <br />APARTMENT <br /> <br />CITY <br /> <br />MAKE <br /> <br />MOOEL <br /> <br />SERIAL,NO. <br /> <br />NATUREOFQ <br />SERVtCE <br />REQUEST <br /> <br />o ESTIMATE <br />o CASH <br />o CHARGE <br /> <br /> <br />QUAN, PART NO. <br /> <br />PRICE <br /> <br /> <br />,./ <br /> <br />/0;; <br /> <br />..--. <br /> <br />f ~".:v~;.--!) <br />~~p.-'--~'~' - :'~',. ;;:-;~--~~ <br /> <br />.:'--'-'-" <br /> <br />-;'-.~"h...>>_ <br /> <br />') <br /> <br />~'" _",:',~:t-::' j'Z- <br /> <br />/J -,," <br /> <br />,'r,: : <br />,-" - <br /> <br />;.,,~,' <br />;.. ,)0 <br /> <br />SERVICE PERFORMED <br /> <br />TOTAl. <br />MATERIAL <br /> <br />TECHNICAL <br />SERVICE TIME <br /> <br />TAX <br /> <br />7~ toJ <br /> <br />DATE COMPlETED <br /> <br />CASH ~~~ON_ TOTAl <br /> <br />TECHNICIAN <br /> <br />CUSTOMER'S SIGNATURE <br />