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<br />Ki~s;;C'C~~;~1 ~~~~. r-' <br />11~7 <br /> <br />Heat & Air-Conditioning, Inc. <br />P.o. Box 2209 <br />Zephyrhills, Florida 33539-2209 <br />(813) 782-2300 <br /> <br />RA0056288 <br /> <br />NAM <br /> <br /> <br />'-.- ....; <br /> <br />'.<- ..,>' <br /> <br />~<' .',~ /;-Y" <br /> <br />17. DATE_OF. ORDER I <br />~.-...<j-r-: :.J ? <br />~ -- <br />DATE PROMISED <br /> <br />ADDRESS <br /> <br />-ff <br />" <br /> <br />'1.1 <br />.~- ",'oJ .,.,1.) ",';.,.;.~ <br /> <br />APARTh4ENT <br /> <br />CITY <br /> <br />MAKE <br /> <br />MOOEL <br /> <br />SERIAL NO. <br /> <br />NATURE OF Q <br />SERVICE <br />REQUEST <br /> <br />o ESTIMATE <br />o CASH <br />o CHARGE <br /> <br /> <br />........""""'-. <br /><i:/ ~ <br /> <br />SERVICE PERFORMED <br /> <br />lOTAL <br />MATERIAL <br /> <br />TECHNICAL <br />SERVICE TIME <br /> <br />TAX <br /> <br />7~ totd <br /> <br />DATE COMPLETED <br /> <br />CASH ~ ~g:LETlON _ <br /> <br />TOTAL <br /> <br />TECHNICIAN <br /> <br />CUSTOMER'S SIGNATURE <br />