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<br />.~, <br /> <br />.. \-" ~ <br /> <br />"''''-----. <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 />17Ni?c~ - 5' a~~ I <br />(..-/0 ,r .3-t, D fZ F <br />'? if 7 () 7 .4v <br /> <br /> <br />! NAME <br /> <br /> <br />ADDRESS <br /> <br />CITY <br /> <br />MAKE <br /> <br />NATURE OF Y <br />SERVICE <br />REQUEST <br /> <br />MODEL <br /> <br />SERIAL NO. <br /> <br /> <br />SERVICE PERFORMED <br /> <br />DESCRIPTION <br /> <br />{' <br /> <br />TECHNICAL <br />SERVICE TIME <br /> <br />7~ ~~/ <br /> <br />A charge of 1.5% will be made on all unpaid balances after 30 days, which is an annual percentage rate <br />of 18% applied to past due balances. Customer is liable for any charges incurred in collecting this bill. <br />DATE COMPLETED <br /> <br />CASH g~ ~g~~LETION _ <br /> <br />TECHNICIAN <br /> <br />CUSTOMER'S SIGNATURE <br /> <br />..' <br /> <br />CA-C058626 <br /> <br />~ATE OF ORDER Ii <br /> <br />'4r-tJ <br /> <br />DATE PROMISED <br /> <br />APARTMENT <br /> <br />o ESTIMATE <br />o CASH <br />o CHARGE <br /> <br />PRICE <br /> <br />AMOUNT <br /> <br /> <br />TOTAL <br />MATERIAL <br /> <br />TAX <br /> <br />TOTAL <br />