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<br />rrom: rAAmaKer <br /> <br />10: /jU4LLL4j~j <br /> <br />J-'age: j/4 <br /> <br />Uate: l/j/2.UU/l:14:b4 J-'M <br /> <br /> <br />FMG Work Order#: <br />0030146550 <br /> <br />Customer Name: <br />KMART - 3761 <br /> <br />Location ID: <br />KM003761 <br /> <br />Date of Dispatch: <br />07/03/2007 <br /> <br />Location Information <br /> <br />Customer Name: <br />KMART - 3761 <br /> <br />Location ID: <br />KM003761 <br /> <br />Address: <br />7422 GALL BOULEVARD <br /> <br />City: <br />ZEPHYRHILLS <br /> <br /> <br />Zip: <br />33541 <br /> <br />Location Phone Number: <br />(813) 783-8181 <br /> <br />Contact Name: <br />MANAGER ON DUTY <br /> <br />On-Site Verification <br /> <br />Step 1: Upon arrival, call FMG at <br />800-306-4122 to check in. <br /> <br />Arrival Time: <br /> <br />I <br /> <br />Departure Time: <br /> <br />I <br /> <br />Number of technicians at location: <br /> <br />I I <br /> <br />Name of technician(s): <br /> <br />I <br /> <br />Step 2: Upon departure, call FMG <br />at 800-306-4122 to check out. <br /> <br />Description of Work Completed (Include all work done and materials used) <br /> <br />I" "'"m trip Modod I <br />to complete this job? <br /> <br />DYes 0 No <br /> <br />Technician Verification <br /> <br />Signature of Technician: <br /> <br />Da te of Service: <br /> <br />Customer Verification <br /> <br />Name of Manager: <br /> <br />I <br /> <br />Signature of Manager: <br /> <br />I <br /> <br />Date: <br /> <br />I <br /> <br />Location Stamp (If no stamp available attach a business card or register receipt): <br /> <br />This fax was sent with GFI FAXmaker fax seNer For more information, visit: http://vwvw,gfi,com <br />