HomeMy WebLinkAboutUsed Mobile Telephone low
1,,1
Ln "'' Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 1 1971
.JUDITH T. TERRY TELEPHONE
TOWN CLERK (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
January 5, 1986
Received used mobile telephone equipment all in accordance with
bid advertisement and payment of $15 .00.
Received By
Relay Communications
r
7
41
FFO
Town Hall, 53095 Main Road
P.O. Box 728
1 Southold, New York 11971
JUDITH T.TERRY TELEPHONE
TowN CLERK (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
December 18, 1986
Mr. Kenter:
This office is still waiting for you to bring in your check in the amount of
$151. 00 and pick up the mobile telephone equipment you purchased from the Town
on October 10th.
z
a
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
JUDITH T.TERRY TELEPHONE
Town CLFRI:
(516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
November 28, .1986
Philip' J. Kenter, President
Relay Communications Center
P. O. Box 596
Riverhead, New York 11901
Dear Mr. Kenter:
On October 10, -1986 this office notified you that you had been
awarded the bid for the purchase of the used mobile telephone equip-
ment of the Town of Southold at a price of $151. 00. This `equipment
has not been picked up. If you would bring your check in' the amount
of $151. 00 to this office at your earliest convenience you may obtain
your equipment, which is stored at this 'office. Thank you.
Very truly yours,
Judith T. Terry
Southold Town Clerk
C=; j +�
Town Hall, 53095 Main Road
P.O. Box 1 179
Southold, New York 11971
_ t y-
JUNTII T.TERRY TELEPHONE.
TOWN('LI R1: (516) 765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
October 10, 1986
Relay Communications Center
P.O. Box 596
145 Griffing avenue
Riverhead, New York 11901
Attention: Philip J. Kenter, President
Dear Mr. Kenter:
Tile Southold Town Board at their regular meeting held on
October 7, 1986 accepted your bid for the used mobile telephone
equipment in the amount of $151 .00.
Very truly yours,
Elizabeth A. Nevill
Deputy Southold Town Clerk
Town Hall, 53095 Main Road
P.O. Box 728
Southold, New York 11971
-1 DIT II T.TERRY TELEPHONE
TOWN CIA RK (516)765-1801
REGISTRAR OF VITAL.STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
October 3, 1986
BID OPENING ON USED MOBILE TELEPHONE
11 :00 A.M. , Thursday, October 3, 1986
One (1) bid was received from Relay Communications Center in the
amount of $151 .00
IRELAYEREM "...For ,ndw Go-
Division of Marken Properties,Inc.
P.O.BOX 596 • 145 GRIFFING AVENUE • RIVERHEAD,NEW YORK 11901 • TELEPHONE (516)727,8300
September 24, 1986
Judith T. Terry
Southold Town Clerk
Southold, NY 11971
Re: Bid on mobile telephone
Dear Ms. Terry:
We hereby submit our bid for one used Harris, Model MT170C standard
mobile telephone with full duplex capability; control head; logic box; radio
box; miscellaneous cable.
Our bid for the above item is: ONE HUNDRED FIFTY ONE ($151.00)
DOLLARS and no/100 CENTS.
Yours truly,
RELAY C MMU ICATIONS CENTER
Philip enter
President
PJK:mos
RELAY Every Hour Every Day
Alarm Systems&Monitoring Pocket Radio Paging Equipment Sales&Service Telephone Answering Service
COUNTY OF SUFFOLK
STATE OF NEW YORK ss:
Patricia Wood, being duly sworn, says that she is the
LEGAL NOTICE Editor, of THE LONG ISLAND TRAVELER-WATCHMAN,
NOTICE TO BIDDERS a public newspaper printed at Southold, in Suffolk County;
and that the notice of which the annexed is a printed copy,
NOTICE IS HEREBY
GIVEN in accordance with the has been published in said Long Island Traveler-Watchman
provisions of Section 103 of the once each week for . . . . . . . . . . . . . . . . . . . . . . . . . weeks
General Municipal Law, that
sealed bids will be received by successively, commencing on the
the Town Clerk of the Town of • • • • • • • • • • • • • • • •
Southold,Suffolk County,New
York at the Southold Town d a - ==t�`�„ 19 r>
Clerk's Office,Southold Town
Hall, Main Road, Southold,
New York, until 11:00 A.M., .. • .. . ...
Thursday, October 2, 1986, at
which time they will be public- --'
ly opened and read aloud, for
the sale by the Town of ,
Southold of the following:One ,
(1)used Harris,ModelMT170C Sworn to before me this . . . . . . : . . . . . . . . . . . . . . day of
standard mobile telephone with
full duplex capability; control ''
head; .logic box; radio box;
.v . . . . . . . . . . . . . . . . . 19 .
miscellaneous cable.Equipment
may be examined at the
Southold Town Clerk's Office
between,the hours of 9:00 A.M.
and 5:00 P.M.Monday through ..< _Ie. -6-__. 1 = -
. . . . . . . . . . . . . . . . . .
Friday. Notary Public
The Southold Town Board
reserves the right to reject any BARBARA FORBES
and all bids and to waive any Notary Fu',lic, State of New York
defect or informality in any bid Na. 48068,16
should it be in the best interest Qual ,i;d in Suffolk County
of the Town of Southold to do C-u nission Expires r''�l. _ 3, 19
SO. i
All bids must be marked"Bid
on mobile telephone",and must
be signed and sealed in
envelopes plainly addressed to
the Town Clerk, Town of
Southold, Town Hall, Main
Road, Southold, New York
11971. Envelope exterior must
also contain the words"Bid on
mobile telephone".
DATED:September 9, 1986.
JUDITH T. TERRY
SOUTHOLD TOWN CLERK
1T-9/18/86(6)
i
COUNTY OF SUFFOLK
STATE OF NEW YORK ss:
Patricia Wood, being duly sworn, says that she is the
Editor, of THE LONG ISLAND TRAVELER-WATCHMAN,
a public newspaper printed at Southold, in Suffolk County;
and that the notice of which the annexed is a printed copy,
has been published in said Long Island Traveler-Watchman
once each week for . . . . . . . . . . . . . . . . . . . . . . . . . weeks
4`
successively, commencing on the . . . . . .
. . . . . . . . . . . .
... . . . . . . . .
da 19 . .
L)
Sworn to before me this . . . . . . �`
. . . . . . . . . . day of
�� . . . . . . , 19 . .
C
Vic ` -.....:. . . . . . . . . . . . . . .
Notary Public
BARBARA FORBES
Notary public, State of New York
No. 4806846
Qualified in Suffolk County
Commission ExpiresC4, -31 19 o"-e
I
i
•
s
�i
Of 9:00 ' M.and 5:00 P.M.Mon-
day tl ;h Friday.
The 6outhold Town Board re-
serves the right to reject any and
all bids and to waive any defect STATE OF NEW YORK 1
or informality in any bid should
it be in the best interest of the 1 SS:
Town of Southold to do so. COUNTY OF SUFFOLK 1
All bids must be marked"Bid
on mobile telephone", and must
be signed and sealed in en-
velopes plainly addressed to the Ka t h a r i n e Ronda rCh u k of Greenport, In
Town Clerk, Town of Southold, said County, being duly sworn, says that he/she is
Town Hall, Main Road, South-
old, New York 11971. Envelope Principal Clerk of THE SUFFOLK TIMES, a Weekly
exterior must also contain the Newspaper, published at Greenport, in the Town
LEGAL NOTICE words `Bid on mobile tele-
NOTICE TO BIDDERS phone". of Southold, County of Suffolk and State of New
NOTICE IS HEREBY GIVEN
DATED:September 9,1986.
TEYork, and that the Notice of which the annexed is
in accordance with the rovi_ JUDITH T.TERRY
P SOUTHOLDTOWN CLERK a printed copy, has been regularly published in
sions of Section 103 of the Gen-
eral Municipal Law, that sealed 13518-5351
said Newspaper once each week for 7-
bids will be received by the 1
Town Clerk of the Town of weeks successively, commencing on the
Southold, Suffolk County, New day of Ra=temher 19 6
York, at the Southold Town
Clerk's Office, Southold Town
Hall,Main Road,Southold,New r
York, until 11:00 A.M., Thurs-
day, October 2, 1986, at which
time they will be publicly
opened and read aloud, for the P ncipal Clerk
sale by the Town of Southold of
the following:One(1)used Har-
ris, Model MT170C standard Sworn to be
is
mobile telephone with full dup- day of fogme th19
lex capability; control head; MARY K DEGNAN
logic box; radio box; miscellane- rj NOTARY PUBLI $tate of New York
ous cable. Equipment may be � Lr�'� / !' -�h .. C,
�!'!t?� Suffolk Courtly No.4849860
examined in the Southold Town Term t0ru Nbruar l9 j��
Clerks Office between the hours a�
i
STATE OF NEW YORK:
SS:
COUNTY OF SUFFOLK:
JUDITH T. TERRY, Town Clerk of the Town of Southold, New
York, being duly sworn, says that she is over the age of twenty-one
years; that on the 9th day of September 19 86 , she affixed a
notice of which the annexed printed notice is a true copy, in a proper
(
and substantial manner, in a most public place in the Town of Southold,
Suffolk County, New York, to wit:
j
!� Town Clerk Bulletin Board, Southold Town Hall, Main Road,
Southold, New York 11971.
Legal Notice, Notice to Bidders: Sale by the Town of one (1) used
Harris, Model MT 170C standard mobile telephone. Bid opening:
11 :00 A.M. , Thursday, October 2, 1986, Southold Town Clerk's j
Office.
;i
;i
Judith T. Terry
Southold Town Clerk
Sworn to before me this
9th day of September 19 86
Notary Public
ELIZABETH ANN NEVILLE
Notary Public,State of New York
No.52-8125850,Suffolk Cou
Term Expires October 31, 19
i
i
i
I
i
LEGAL NOTICE
NOTICE TO BIDDERS
NOTICE IS HEREBY GIVEN in accordance with the provisions of Section
103 of the General Municipal Law, that sealed bids will be received by the
Town Clerk of the Town of Southold, Suffolk County, New York at the
Southold Town Clerk's Office, Southold Town Hall, Main Road, Southold,
New York, until 11 :00 A.M., Thursday, October 2, 1986, at which time
they will be publicly opened and read aloud, for the sale by the Town of
Southold of the following: One (1) used Harris, Model MT170C standard
mobile telephone will full duplex capability; control head; logic box; radio
box; miscellaneous cable. Equipment may be examined at the Southold Town
Clerk's Office between the hours of 9:00 A.M. and 5:00 P.M. Monday through
Friday.
The Southold Town Board reserves the right to reject any and all bids
and to waive any defect or informality in any bid should it be in the best
interest of the Town of Southold to do so.
All bids must be marked "Bid on mobile telephone", and must be signed
and sealed in envelopes plainly addressed to the Town Clerk, Town of
Southold, Town Hall, Main Road, Southold, New York 11971. Envelope
exterior must also contain the words "Bid on mobile telephone".
DATED: September 9, 1986.
JUDITH T. TERRY
SOUTHOLD TOWN CLERK
PLEASE PUBLISH ONCE, SEPTEMBER 18, 1986, AND FOWARD ONE (1)
AFFIDAVIT OF PUBLICATION TO JUDITH T. TERRY, TOWN CLERK,
TOWN HALL, MAIN ROAD, SOUTHOLD, NEW YORK 11971.
Copies to the following:
The Long Island Traveler-Watchman
The Suffolk Times
Town Board Members
Town Clerk's Bulletin Board
Dodge Reports
1
I�
I
11
LEGAL NOTICE
NOTICE TO BIDDERS
NOTICE IS HEREBY GIVEN in accordance with the provisions of Section
103 of the General Municipal Law, that sealed bids will be received by the
Town Clerk of the Town of Southold, Suffolk County, New York at the
Southold Town Clerk's Office, Southold Town Hall, Main Road, Southold,
New York, until 11 :00 A.M., Thursday, October 2, 1986, at which time
they will be publicly opened and read aloud, for the sale by the Town of
Southold of the following: One (1) used Harris, Model MT170C standard
mobile telephone will full duplex capability; control head; logic box; radio
box; miscellaneous cable. Equipment may be examined at the Southold Town
Clerk's Office between the hours of 9:00 A.M. and 5: 00 P.M. Monday through
Friday.
The Southold Town Board reserves the right to reject any and all bids
and to waive any defect or informality in any bid should it be in the best
interest of the Town of Southold to do so.
All bids must be marked "Bid on mobile telephone", and must be signed
and sealed in envelopes plainly addressed to the Town Clerk, Town of
Southold, Town Hall, Main Road, Southold, New York 11971. Envelope
exterior must also contain the words "Bid on mobile telephone".
DATED: September 9, 1986.
JUDITH T. TERRY
SOUTHOLD TOWN CLERK
PLEASE PUBLISH ONCE, SEPTEMBER 18, 1986, AND FOWARD ONE (1)
AFFIDAVIT OF PUBLICATION TO JUDITH T. TERRY, TOWN CLERK,
TOWN HALL, MAIN ROAD, SOUTHOLD, NEW YORK 11971.
Copies to the following:
The Long Island Traveler-Watchman
The Suffolk Times
Town Board Members
Town Clerk's Bulletin Board
Dodge Reports
Pal/
LEGAL NOTICE
NOTICE TO BIDDERS
NOTICE IS HEREBY GIVEN in accordance with the provisions of Section
103 of the General Municipal Law, that sealed bids will be received by the
Town Clerk of the Town of Southold, Suffolk County, New York at the
Southold Town Clerk's Office, Southold Town Hall, Main Road, Southold,
New York, until 11 :00 A.M. , Thursday, October 2, 1986, at which time
they will be publicly opened and read aloud, for the sale by the Town of
Southold of the following: One (1) used Harris, Model MT170C standard
mobile telephone will full duplex capability; control head; logic box; radio
box; miscellaneous cable. Equipment may be examined at the Southold Town
Clerk's Office between the hours of 9:00 A.M. and 5:00 P.M. Monday through
Friday.
The Southold Town Board reserves the right to reject any and all bids
and to waive any defect or informality in any bid should it be in the best
interest of the Town of Southold to do so.
All bids must be marked "Bid on mobile telephone", and must be signed
and sealed in envelopes plainly addressed to the Town Clerk, Town of
Southold, Town Hall, Main Road, Southold, New York 11971. Envelope
exterior must also contain the words "Bid on mobile telephone".
DATED: September 9, 1986.
JUDITH T. TERRY
SOUTHOLD TOWN CLERK
PLEASE PUBLISH ONCE, SEPTEMBER 18, 1986, AND FOWARD ONE (1)
AFFIDAVIT OF PUBLICATION TO JUDITH T. TERRY, TOWN CLERK,
TOWN HALL, MAIN ROAD, SOUTHOLD, NEW YORK 11971.
Copies to the following:
The Long Island Traveler-Watchman
The Suffolk Times
Town Board Members
Town Clerk's Bulletin Board
Dodge Reports
xwuuu.rwlaWY�y �L.Yi+ .�.f .�.eI.J.I...... "Ago I AlW'Ili Iu .hili 11. 1. f„ 1.11.1
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Memo . . . �,FF°u
`k
From the office of the SUPERVISOR
MAIN ROAD,SOUTHOLD,NEW YORK 11971
(516)765-1800
��Ap
✓Y1 -� �. � � l /dam
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,sla-.49- �a �3
r RELM COMMUNICATKM CENTER
•��Mo�•MobM�lMn�s
MOM !sots•Eleehoak Equ*•Son i SmIm
P. O. Box 596. 145 Gilft Avmw Cal e
RIVERHEAD. NEW YORK 11901
(526)727$300
❑SERVICE ❑PICK UP PHONE REPAIR IN DATE OF ORDER
❑INSTALL ❑DELIVER `�(r;—) `slsb ❑HOME ❑SHOP 192 1 ,r)
- NAME (� \ DATE PROMISED
ADDRESS APARTMENT
CITY DATE OF ORIG.INSTAL.
MAK y MODEL SERIAL NO. ❑ESTIMATE
s ISi) ❑WARRANTY
_ ❑CONTRACT
NATURE OF ❑CASH
SERVICE
REQUEST [:]CHARGE
- ❑C.O.D.
QUAN. PART NO. DESCRIPTION PRICE AMOUNT
15n1 rd)
1
Y)-).)--,C lOk f i
1
1
1
SERVICE PERFORMED _
TOTAL 1
'-MATERIAL
- - .TECHNICAL 1
SERVICE 1
TIME
1
TAX 1
DATE COMPLETED A �J ON COMPLETION - I
^) "_ CASH of WORK TOTAL
—� 1
.� I hereby accept above`performed service,`and charges,es being satis-
-- SHO OPY factory and acknowledge that equipment has been left in good condition.
t Technician Customer's Signature
DELIVERY INSTRUCTIONS ON REVERSE SIDE
RELAY "...For hwh a dw Goy ft
Division of Marken Properties,Inc.
P.O.BOX 596 • 145 GRIFFING AVENUE • RIVERHEAD,NEW YORK 11901 • TELEPHONE (516)727-8300
December 12, 1983
William R. Pell III
Supervisor
TOWN OF SOUTHOLD
Main Road
Southold, New York 11971
Ref: Mobile Telephone Proposal
Dear Supervisor Pell:
This will confirm the recent meeting with you, the Supervisor Elect, Chief
Of Police and Dennis Kenter of our office. The purpose of the meeting was
to demonstrate our standard mobile telephone service to you.
The mobile telephone unit, as you saw, looks like a Princess telephone.
With use of our radiotelephone facilities, it can be used substantially
throughout Suffolk County. The unit has what is known as "Full Duplex"
capability. This means that the caller and the listener can talk simultaneously
as compared to a typical two-way radio type which only allows one person at a
time to talk while the other listens. The mobile telephone will have its own
unlisted telephone number; the point of origin for that number will be Riverhead.
There is a possibility that we may be able to obtain a previously owned unit
for you; that unit, if available to us, is less than a year old and was seldom
if ever used. The warranty on that unit would be the same as a new unit; i.e. ,
ninety (90) days - parts and labor. The savings with a previously owned unit
amounts to $500.00; the cost of a new unit is $3,000.00 including installation.
Use of the mobile telephone also involves monthly charges. There is a flat
monthly charge of $35.00 for the use of our facilities which also includes the
receiving of 100 two minute calls. There is a separate and additional charge of
$1.00 for each outgoing call from the mobile telephone with a maximum talking time
of two minutes; one additional talking time minute is automatic but at a chargeable
cost of $1.00. In addition to these charges, there is also an access charge of
25¢ to make an outgoing call within the 516 area; however, the access charge is
subject .to change without notice when the present rates by New York Telephone
and American Telephone & Telegraph become obsolete. We do not know what the
filed tariffs by those companies will be; needless to say, our rates are contingent
upon theirs.
We will arrange with you to have your vehicle available to us in the morning.
It will be transported to our installation facility and will remain with us for
not less than 24 hours. It will be returned the following day at which time
a detailed explanation of its use will be given to you or your designee.
RELAY Every Hour Every Day
Communications Consultants . Pocket Radio Paging • Private Telephone Systems • Telephone Answering Service
Alarm Systems&Monitoring . Car Telephone Service . Equipment Sales&Service . Cable TV Management&Brokerage
' Southold./Pell -2- 12/12/83
In view of the fact that payment will not be made until after delivery, we
will ,require a Purchase Order in advance with a detailed description based
on this letter proposal. The Purchase Order will indicate all the applicable
charges. Payment in Full will be required within ten (10) days after install-
ation; this will also be stated on the Purchase Order. 'Such payment will
include the full cost of the mobile telephone unit plus the first month's
basic', service charge of $35.00. In the event there is a technical problem
within the ten (10) day interim, every effort will be made to repair same
without delay; however, the Purchase Order will so state that payment will not
be delayed nor withheld pending completion of such repairs.
Enclosed herewith and made a part hereof is our standard application for
service. There are certain data requirements which will be waived in lieu
of your Purchase Order; i.e. , personal guarantees of individuals, etc.
Never'theless' the Terms and Conditions on the reverse side thereof will apply.
This application form MUST be returned to us fully executed and with your
Purchase Order before we can proceed with your order.
If you have any questions whatsoever, please call the undersigned or Dennis
Kenter directly.
We look forward to being of service to you.
Yours truly,
RELAVCOMMWICATI9NS CENTER
p
Philip 9 YKent e
President
PJK:mos
1
Town of Southold
BILL OF
. , . . ,�,�Q�y,COY111'11�1iC�r.hO►�
For Services and
Disbursements as
Claimed, $. . . .o? ���.•,OO. . .
Allowed,
Audited . . . . . . . . . .
G'terk��
* ........RIVERHEAD...........................I N. Y.,.............FEB..1....1984... -
' TOWN OF SOUTHOLD, COUNTY OF SUFFOLK, N. Y., Dr.
To. RE�;AY. f;-Q MW:krAT ION, --UNTER ER...........................
Address.....P.O:..BOX,596................ iVERHE�P.,..I`7.,X..�.�.��a...
Fed. I. D. No. .....�,7,-.Z2.0�:1.51........
or Soc. Security No. ........................
qW
. The undersigned (Claimant) (Acting on behalf o e named Claimant) does hereby certify that the
(Cross out one)
foregoing claim is true and correct and that no pa thereof has been paid, except as therein stated, and
that the balance therein stated is actually due and owing.
Dated .....................I-f. 119............ 19....8 4....
..'- . .,.. ..I ... ... .�. .................. . .....
7 Signature
i
� c�
INOCE
RELAY COMMUNICATIONS CENTER
145 GRIFFING AVE. P. O. BOX 596,
RIVERHEAD NEW YORK 11?01
PHONE: (516) 727 - 8300
I.D. No�'
I-OWN I.-jF SOUTHOLD 487
ACCOUNTS PAYABLE
ATEMENT DATE
53095 MAIN STREET 71- FEB-
SOUTHOLD, N. Y. 11952
INVOICE # 11537
DATE DESCRIPTION CHARGES CREDITS BALANCE
------- PREVIOUS BALANCE $0. 00
I-FEB-84 CURRENT BALANCE $0. 00
I-FEB-84 MONTHLY CHARGE $0. 00 $o. (:)0
l-FEB-84 SPECIAL SERVICES $2645. 00 $2645. 00
MOBILE PU
I-FEB-84 SALESTAX $0.00 $2645. 00
.ESSAGE PERI DIED: DEQ: 23-JAN 22; PAYMENTS JAN 24:
HANK YOU FOR YOUR PROMPT PAYMENT. ARE YOU
WARE OF OUR SERVICES TO MAKE YOUR BUSINESS
ORE EFFICIENT AND PROFITABLE? CALL US FOR
!ETAILS AND DEMONSTRATIONS. STOP IN AND SEE
;UR NEW EQUIPMENT AND COMPUTERIZED OPERATION.
)WED FOR 30 DAYS OWED FOR 60 DAYS I OWED FOR 90 DAYS OWED FOR MORE
THAN 90 DAYS
$0. 00 $0. 00 $0. 00 $0.00
PAY THIS AMOUNT $2645. 00
THANK YOU FOR LETTING US SERVE YOU ! !
r
Ann* RELAY COM MTIONS Cm
?AdbftgQAr ' o � Na 4152
P. O. Box 596 a 145 Grff&V Avwm
RIVERHEAD, NEW YORK 11901
(516)7274OW
0 SERVICE ❑PICK UP PHONE REPAIR IN DATE OF ORDER
NSTALL ❑DELIVER 6 5- 1 z O-0 ElHOME [I SHOP 49- 3- 1911
- 3- 191
NAME jj �+" DATE PROMISED r
._>a
T O ou -'
ADDRESS APARTMENT
CITY DATg OF O O.INSTAL
PAI 8
!MAKE IMODEL SERIAL NO. El ESTIMATE
V
r r i co>, �^ 7��/�F'19 -17 ❑WARRANTY
X80 5-Oa n" "�,a T�. 1 [_1 CONTRACT
NATURE ❑CASH
SERVICE
L� _ ❑
REQUEST CHARGE
- ❑C.O.D.
QUAN. PART NO. DESCRIPTION PRICE AMOUNT
- 1 -
�� h '. G19'.
—t—
io r• Lon rd �ewd w
0 1 oc5 Oa
G bl'_ COW oa e V-)O1- '
I
V SCJ baa o0
,
SERVICE PERFORMED .. i 2 2- p - TOTAL
MATERIAL 1
r 1
TECiHNICAL ,
SERVICE 1
TIME
.9= TAX
COMPLETION ASH OF WORKTOTAL S 9L-6x'1�4l
O
1 hereby accept above performed service,and char ea,as being sans
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a SHOP COPY, factory and acknowledge that equipment has teen ieft in good conditbe.
Technician Customer's Signature
DELIVERY INSTRUCTIONS ON REVERSE SIDE