2604 BAKER AVE 2022-04-12 - Laserfiche WebLink

BACKWATER PREVENTION PROGRAM 4mrr INVOICE COST BREAKDOWN Please use this Invoice Cost Breakdown as a template for invoices submitted as part of the Backwater Prevention Device rebate program. Either this form or your own invoice form with the following line items can be submitted. This allows you to invoice your client according to your existing billing template while allowing city staff to identity how costs eligible for the Backwater Prevention Device Rebate were accrued. Only labor and materials directly related to the installation and function of a backwater prevention device are eligible for City rebate and therefore should be Included on the upper half of this form. Additional costs may be added to bottom of the form. Business Name Business Mailing Address: ()(Oil V 0 / Phone: At-2- _ Email License Number. elu /* 611 PID z-IVk4 6r r- Fd-7 09 Cate o Description Units Quantitv Rote Total Administration Administration / management Hours Labor CCTV Inspection Hours _ GO BWV Install Hours I'1 Pipe replacement Hours _ Surface restoration Hours Site cleanup Hours Downspouts I drainage imp. Hours Materials_ Backwater valve Per Unit Grinder pump Per Unit _ Side sewer pipe (up to 8 feet) Feet O Imported Backfill Yards Surface Restoration Materials (top soil, grass seed, concrete, etc. Lump sum 1 Cover (irrigation box or load bearing cover Per Unit ( (ep O Rentals S y e ui ment Hour 9''S-ypto dU — — Fees Disposal fees bItem Yards Delivery fees if not covered by labor EII ible Total $ ' Other Costs Costs not associated with BWD, and not edible for rebate detail below) Ineligible Total IS TotalI 3 O v Revised 910312014