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<br />A.RAIN' JUNG~ <br /> <br /> <br />;EWER & DRAIN CLEANING <br />.' Floor Drains · TOilets <br />Mainlines · <br />Bathtubs · Sinks . 0' <br />Locating <br />waterJ~~r\ln~~~&~I;'-lk)J <br />~ -- - ~ ~ Mpls: Office <br />'JU'" . - 24 Hour rvlce 100 <br />North Of lice E t' ates 588-2 <br />000 Free s 1m <br />1\_ 786-3 . <br />~\r . _' _ -n'T "-"\: 1 \. <br />Address (... q ,? ~ (" e Vi i-</ tJ" II t' f2 .( <br /> <br />City ( C-. ~ e reN II ( State_ Zip <br /> <br />tAlN KING~ <br />\lD DRAIN CLEANING <br />92, BLAINE, MN 55449-0092 <br />(612) 786-3000 <br />:E I STATEMENT <br /> <br />INDUSTRIAL <br />MUNICIPAL <br />16747 <br /> <br />Date / ~ '3 ~ Otl <br />Phone b ~I- & <::>'5 . 93 F cJ <br /> <br />Phone <br />Time In ~ Is;- Time Out "7:; I s- <br />,..-r-- <br />Serviceman's Signature ~ ~ <br /> <br />Serviced at <br />Referred by <br /> <br />1. ESTIMATE My estimate for performing this work is for $(.StJ./---.l.. hr(s). Additional labor is $/.:o.>/~ hr(s). For <br />2. ESTIMATE My estimate for performing this work is for $.$(1,. /~. rr(s). Additional labor is $_/_ hr(s). For <br />~." <br />3. ESTIMATE My estimate for performing this work is for $_/_ hr(s). Additional labor is $~_ hr(s). For <br />WORK AUTHORIZATION I authorize Drain King Inc. to perform the described services and I agree to pay the amounts indicated. I <br />understand the Drain King Inc. is not responsible for broken, settled, rusted, deteriorated, or lead pipes, fixtures, or clean outs and any <br />damage resulting from cleaning such lines. <br /> <br />(Print Name) <br /> <br />(~ ,tA-f ~ <br />bow br~ <br /> <br />(Signature) <br /> <br />COST <br /> <br />SERVICES <br />o Hydrojetting <br />~ Line Inspection <br />o Mainline <br /> <br />COMMENTS <br /> <br />--Iu <br /> <br />J+cw1 <br />O~' <br />, _V1 c',a/).c--(/',(1 FC:l,I4J ~rc:e;, Ii <br />1!11 rpt. t.J 0 l-t + $,1) ~ (" l-c'ef"j,f .;.;::,.... +- ct #lid <br />4'+ d ) 7 ' r: jI'tJ;ot... ~ '-1 s~J f r I r"e:; tA .,~'" 1- <br /> <br /> Floor Drain <br /> Kitchen Sinks <br />0 Bath Tub <br />0 Bath Sink <br />0 Toilet <br />0 Urinal <br />J Laundry Tubs <br />C) Other <br /> <br />('u......, <br /> <br />blow <br /> <br />.~ <br /> <br />o~ <br />, <br /> <br />Ioer '"') <br />c:7 <br /> <br />PREVENTIVE MAINTENANCE (10% discount) 0 6 Mo. 0 12 Mo. <br />o 18 Mo. 0 24 Mo. <br /> <br />o 6 Mo. (roots only) ~one <br /> <br />-.61 Check 0 Discover 0 Master Card <br /># '"Su33 <br /> <br />SUB TOTAL LABOR <br />DISCOUNT <br />TOTAL LABOR <br />TOTAL PARTS <br /> <br />TOTAL ':;1.$ o. C/o <br /> <br />GUARANTEE 0 30 Days <br /> <br />PAYMENT TYPE 0 Cash <br />J Visa 0 Other Terms <br /> <br />Credit Card # <br /> <br />Expiration Date <br /> <br />Signature <br /> <br />PLEASE READ BEFORE SIGNING <br />. Our company is not responsible for deteriorating plumbing or leaks caused by deteriorating plumbing and we are not responsible for any <br />d2mages caused by back-up during guarantee period. <br />. A 520.00 charge will be added to all dishonored checks, and you will be responsible for any legal costs incurred in collection of money. <br />Commercial Accounts: Terms = Net 30 A finance charge of 1 % % per month or 18% per annum will be assessed on late payments. <br /> <br />Did ~ iceman: Provide satisfactory service? 0 Yes 0 No Offer 2nd line discount? 0 Yes 0 No e sticker? 0 Yes 0 No <br /> <br /> <br />(Comments) <br />