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<br /> <br />ftfrf.-- <br />'~D <br />], <br /> <br />. <br /> <br />NAME <br /> <br />ADDRESS <br /> <br />CITY <br /> <br />MAKE <br /> <br />NATURE OF Q <br />SERVICE <br />REQUEST <br /> <br />e: '." It <br /> <br />SERVICE PERFORMED <br /> <br />Kinsey Central <br /> <br />Heat & Air-Conditioning, Inc. c~ <br />P.O. Box 2209 c., ~ _ Cf 05"7 <br />Zephyrhills, Florida 33539-2209 7;gt-?;J <br />(813) 782-2300 ~RA0056288 <br /> <br />I PHONE" IS--~ 0 ~;l. ~ I DATE OF ORDER I <br />/ , "v uJ; II J2-/ <br />/' <rStJ. <br /> <br /> <br />DATE PROMISED <br /> <br />APARTMENT <br /> <br />MODEL <br /> <br /> <br />SERIAL NO. <br /> <br />o CASH <br />o CHARGE <br /> <br />DESCRIPTION <br /> <br /> <br />PRICE <br /> <br />TOTAL <br />MATERIAL <br /> <br />TECHNICAL <br />SERVICE TIME <br /> <br />7~~ <br /> <br />A charge of I.So/liI will be made on all unpaid balances after 30 days. which is an annual percentage rale <br />of 18% applied to past due balances. Customer is liable for any charges incurred in collecting this bill. <br />DATE COMPlETED <br /> <br />TOTAL <br /> <br />TECHNICIAN <br /> <br />TAX <br /> <br />CASH ~~~~ION _ <br /> <br />CUSTOMER'S SIGNATURE <br />