2005
Meadowlands Leadership
Award Winner
For outstanding leadership & service to the Business Community of the Meadowlands
WORK ORDER & ASSIGNMENT AUTHORIZATION FORM
Check-M-Out Security Services & Investigations, LLC
47 Bloomfield Avenue, Caldwell, NJ 07006
Phone: 973-403-8362 Fax: 973-403-8197
Email:
Info@CheckMOut.Com
Fax To:
Fax #:
Date Assigned:
Day
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Year
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CMO Case No:
Intake Staff Initials:
Client Name:
Position/Title:
Client's Firm/Company:
Address:
City:
State:
New Jersey
Alabama
Alaska
Arkansas
Arizona
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
Washington D.C.
West Virginia
Wisconsin
Wyoming
Other:
Country:
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua
Argentina
Armenia
Aruba
Austria
Australia
Bahamas
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bolivia
Botswana
Bouvet Island
Brazil
Bulgaria
Burkina Faso
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Chile
China
Christmas Island
Colombia
Costa Rica
Croatia
Cuba
Czechoslovakia
Denmark
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Ethiopia
Falkland Islands
Fiji
Finland
France
Georgia
Germany
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guinea
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kenya
Korea
Kuwait
Laos
Latvia
Lebanon
Liberia
Libya
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malaysia
Mali
Malta
Marshall Islands
Martinique
Mexico
Monaco
Mongolia
Montserrat
Morocco
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
Neutral Zone
New Caledonia
New Zealand
Nicaragua
Nigeria
Norfolk Island
Northern Mariana Islands
Norway
Pakistan
Panama
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Romania
Russian Federation
Rwanda
Saint Lucia
Samoa
Saudi Arabia
Senegal
Singapore
Somalia
South Africa
Slovenia
Spain
Sri Lanka
Sudan
Suriname
Swaziland
Sweden
Switzerland
Syria
Taiwan
Thailand
Togo
Trinidad
Tonga
Tunisia
Turkey
Uganda
Ukraine
United Kingdom
Uruguay
USSR - former
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands
Western Sahara
Yemen
Yugoslavia
Zaire
Zambia
Zimbabwe
Other:
Zip Code:
Case Name:
Client's File No.
CHECK-M-OUT
agrees to conduct the following assignment based upon the written stipulations within this Work Order & Assignment Authorization. The agreed upon budget and/or retainer for this assignment will not be exceeded without signed, written authorization from the client or party responsible for payment. Any revisions to this assignment will require a new executed Work Order & Assignment Authorization setting forth the updated revisions and budget. ASSIGNMENT
Agreed upon retainer amount:
$
Date Report Due:
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Month
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Year
2004
2005
2006
2007
Authorized Budget:
$
As case is invoiced to client, client's firm/company and client, as agent of firm/company, agree to pay invoice total in full within 30 (thirty) days from date of invoice. If the balance is not paid within the stipulated 30 (thirty) day grace period, a 1.5% finance charge will be assessed for each month the account remains past due (18% per annum ). Client is responsible for all additional charges above the original balance after 30 (thirty) days. If the account goes to collection, an additional fee of 30% (thirty percent) will be added to the total amount due. ACCEPTANCE AND AUTHORIZATION OF ASSIGNMENT
Signature of Client:
Phone Number:
Email Address:
Check-M-Out Security Services & Investigations, LLC
47 Bloomfield Avenue, Caldwell, NJ 07006
Phone: 973-403-8362 Fax: 973-403-8197
Email:
Info@CheckMOut.Com