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<br />I , I PHONE ~7 .2.~ ~i~A; ~O:~:" I <br /> - -~ -., <br /> ,~_.'~'" - ,- <br />NAME --~~ / DATE PROMISED <br /> -' ,,() ..;. .,4 <br /> . " L' F,--r .. - <br />ADDRESS - , ~ -' -r h-::.....r:? APARTMENT <br /> .' ~i' , C - <br /> ;c , - :::t' <br /> ,; ,.,.. .- . <br />CITY <br />MAKE T MODEL T SERIAL NO. <br /> - 0 ESTIMATE <br /> -<I 1'0- <br />NATURE OF Q !-cz./ ~. 0 CASH <br />SERVICE g>--.2~ -..2../-0 c: S1-.7- CO Cc 0 <br />REQUEST c_ { :?.2..c 0 CHARGE <br />QUAN. PART NO. DESCRIPTION PRICE AMOUNT <br />.- - -.' -...,.T ......~ <br />-, ~. '1 .~ .:.e: . ,;.-'_~' -. '- <br /> ,.'....... r -"-, - -- <br /> - .::::. -_l;;<-~ ~- ~ 1 <br /> _",' -'-. ~. ~-}?""c <br /> ~ ~ <br /> I <br /> 1 <br /> I <br /> I <br /> . <br /> : <br /> I <br /> ! <br /> T <br /> <br />Kinsey Central <br /> <br />Heat & Air-Conditioning, Inc. <br />P.O. Box 2209 <br />Zephyrhills, Florida 33539-2209 <br />(813) 782-2300 <br /> <br />CA-C058626 <br /> <br />SERVICE PERFORMED <br />? ~ <br />/ <br /> <br />'..:.......,. <br /> <br />.- <br />"-. <br /> <br />TOTAL <br />MATERIAL <br /> <br /><:"..l. x_ <br /> <br />TECHNiCAl <br />SERVICE TIME <br /> <br />. J <br />'(,,'.L-'..,~ ,j. <br />' /' ~ -- ....- ", -r-" '!'"-_";;. ,"':,.A;.,.. ./i+-? r''- <br /> <br />A charge of 1.5% will be made on all unpaid balances aller 30 days. which is an annualperc';tage rat.. ,>, -rNX. <br />of 18% applied to past due balances. Customer is liable for any charges incurred in collectIng this biJt.-- ' <br /> <br />DATE COMPlETED <br /> <br />7~~ <br /> <br />CASH ~~g~~ION _ <br /> <br />TOTAL <br /> <br />TECHNICIAN <br /> <br />CUSTOMER'S SIGNATURE <br />