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Stomatt'a, Travie
1234 e5th st
Jax. , MD
Cell:
Home:
Work:
Vehicle:
VIN:
Created:
Odometer:
Tag:
Type Description
Labor Labor
Part No
UP
SD880389KT2
FLT FT880389
381-330-8004
Total
$212.50
$498.00
$498.00
$176.78
$176.78
$7.50
$62.63
$957.41
I do _____ do not _____ request the return of replaced parts. Flat Rate/ Hourly Rate/ Both Apply If your vehicle is not picked up within
72 hours after completion of work performed, customer agrees to a daily storage fee of not more than $50.00. Customer further agrees
that the repair shop will not be liable for the vehicle or articles left in the vehicle in case of fire, theft, accidents or other causes beyond
control. My vehicle may be driven by your employees for road testing at my risk.
SIGNED_________________________________________________________ DATE______________________
Estimates are valid for 5 Days
Payment Type: CASH___ CHECK___ CHARGE___ OTHER___