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Hi,

Customer/Point of Contact:

Pacific Retina Specialists
Marie Paulin (+1 (671) 649-3937)

Scheduled Date/Time:

07/31/2018, 02:00 pm

Service Type:

Onsite

Charge Type:

Normal

Charge Code:

DSIG.4045: Standard Service 2018

Rates:

Standard Service Rate [TOTAL ANNUAL HOURS: 2]

Remaining Hours:

Est. Service Time (hrs):

Reference/PO #:

Taken By:

Jordan Gimmen

Customer Signature:

Yes

Print Name:

Marie Paulin

Date Signed:

07/31/2018

Invoice Number:

027174

Set up AP

Work Requested by:

Work Completed :

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