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<br />~.."......~ _,~ <-d <br />~UARD <br /> <br />INDUSTRIES. INC, <br /> <br />CHANGE ORDER <br /> <br />FACTORV <br />6790 11 8th Ave, N, <br />Largo, FL 33773 <br />(727) 541-6648 Fax 544-3825 <br />Toll Free 1 -800.833-5665 <br /> <br />FT. MYERS OFFICE <br />1222 Hemingway Drive <br />Fort Myers, FL 33912 <br />(941) 267-6833 <br />Fax (941) 267-6887 <br />Toll Free 1-800-833-5665 <br /> <br />STATE CERTIFICATION <br />ROOFING CONTRACTOR. CCC055597 <br />ROOFING CONTRACTOR, RC 006. 080 <br />SPECIALTY CONTRACTOR, SCC 052644 <br />SPECIALTY CONTRACTOR. SCC 045074 <br />HOME IMPROVE, CON'T: . HC 0001309 <br />INSTALLMENT SALES. HR 0048544 <br /> <br />~!'~,..w.,>> .i~ ~,~ ) (2l.Tffl,I{J (~)t:e- <br />\" {/ , ~ f!t.r' It . <br /> <br />STREET b I OS- {i7Tfr 'fj-Jl.;t:t":' I <br /> <br />CITY, STATE 2FjjJH-tUl'tthL6 -..f'L ,"';;:554--1 <br />I I I <br />,J '" '" l ,"'- ' , f <br />c:itAtJBt-: t.':-OOG 6,t.lbF' li?etMIlJ11,.\,;VlluYt" ~.fbl:(ct., 6bfl~ DD0t25. <br />-~ ,!' '. 1\ '---. _ \ <br />J u .. f\;ll (v(i Jti ,1.>\ '~\-~.iiF SiA hi tJ4, e~Lfv!:6 ))lJ{) iL ['Lx.) , f.,JO St~fLb"eIJ6 <br /> <br />Swetl/PES s.';+t:fijJk~ Sltf3l/ ~DtLei2, '~,I2-I-;:~:; 'f-#\~~lLJAAL7 -fDQ..,' <br />ClJ!2(109Vt? f(2VDf-! Pl\f'.tT>) h)DOb '~\i'rUt>L-l7.S J l)J;V L-CLi/t:,~ <br /> <br />Jl~\, "'~', .---~ _.," ~,~ ~ ,., ()~ '. ..' . ,', , '.,,' <br />'2!:::.!::. rltl(lii,~ h,rr rt:-(1.lt'IV DOt'iKc.. t1:'II lID {\-{PH-, I.A..)t1J'b. '2t.!I..Jb' - ~l tJ11 '..L;)fCLft1eb <br />.' '"" ,....,..1',..:1- ',; ,l - ,'I..:::.... '-:-' \~~, ,.J:> -'-.r. ;~""''\... ~ A >~_." <br />.XGfL-'ji~i ,Gt...tL~ ~ tf'vfrt I ~ i~' CVLt/L IIILI G ;:;,~,; t---i6. L:{.jOV..c... (:t>{vveS kJ i"TH~ <br />! 'Ht2BS~-~)L:D i t>rnbf3ti(~T'j' ~!-.~i~}I5! ILFV LDC-lL. i 'tVJ h (~J~>k::(EL!.. OH-A~J f-J . <br /> <br />NAME <br /> <br />DATE <br /> <br />0, J 2-.4,1 lQ__ <br />(gg) 7tr2-- bl)ib <br />63.~ ""1~1 <br /> <br />PHONE <br /> <br />ZIP CODE <br /> <br />. <br /> <br />)L\-bb <br /> <br />-"'1 '- ^ ...~ <br />I /1'-'<<'hll/r;:..jd <br />L-"v --' fl....f"j.'I..- jL' <br /> <br />OJ' ,'-- ,.";' -:. '-" l) <br />fi;.........c::;::"Vll ue.~# !2..; ~ ""-r;i".l <br />t.' "'-," ,.- '-'" =V' t./ t[.'~ <br /> <br />- , ... <br />-r'l""f7'j'*0.4~-f:') h /1 <br />c:- -~,.-'-; F--l/l,...p-J <br /> <br />..11.".. <br />'i?,;:) <br /> <br />.)' 'Cj..,.-:'t,.'d b <br />e..'t;;;"V r-'I;.' {. <br /> <br />AMOUNT OF ORIGINAL CONTRACT <br />. <br /> <br />DOLLARS $ <br /> <br />.;-'/"':: r;- .==-' rO'}"n <br />'7<./7.j e/b <br />Q;r,o ~tr; <br />, (,;},f ,I. t;,/'Cd' <br />I <br /> <br />AMOUNT OF ADJUSTMENT m <br />ORIGINAL CONTRACT (... or -) <br /> <br />fij <br />( <br />[--) <br /> <br />DOLLARS $ - <br /> <br />If} l) t), flu <br />,', <br />/jr; ..-;- -'r' <br />VB 7J . Vv <br /> <br />DOLLARS $ <br /> <br />LESS DEPOSIT <br /> <br />BALANCE DUE <br />(PEA PAYMENT TERMS ON ORIGINAL CONTRACT) <br /> <br />DOLLARS $ <br /> <br />"BUYERS RIGHT m CANCEL: THIS IS A HOME SOLICITATION SALE. AND IF YOU DO NOT WANT THE GOODS OR SERVICES, YOU MAY CANCEL THIS AGREEMENT <br />BY PROVIDING WRITTEN NOTICE m THE SELLER IN PERSON, BY TELEGRAM, OR BY MAIl. THIS NOTICE MUST INDICATE THAT YOU DO NOT WANT THE GOODS OR <br />SERVICES AND MUST BE DELIVERED OR POSTMARKED BEFORE MIDNIGHT OF THE THIRD BUSINESS DAY AFTER YOU SIGN THIS AGREEMENT. IF YOU CANCEL <br />THIS AGREEMENT. THE SELLER MAY NOT KEEP ALL OR PART OF ANY CASH DOWN PAYMENT." <br />,-' <br /> <br />REPRESENTATIV~~F ~ l/ ( ./ (;(/ <br />PERMAGUARD t ,4<:.......... ,,--............,~.C~'--~~ <br />I /' <br />I DATE c1f 12-'4/. () 2..._ <br /> <br />'/'j' /J <br />.:. .~. ~/j.~/J <br />PURCHAS;f\."" ,-:U '.... , <br />(/' <br />, , <br /> <br />PURCHAS'ER <br /> <br />ill <br />Jl.z <br />;;-...;,r, <br /> <br />/-"'7 /."") <br />/' /'~- I.',../'.7 <br />Cd.../'C.e---- <br /> <br />DISTRIBUTION: WHITE: Original CANARY: Customer PINK: Salesman <br />