4926 COLBY AVE 2022-04-14 - Laserfiche WebLink

BACKWATER PREVENTION PROGRAM 4 � INVOICE COST BREAKDOWN Please use this Irivoice Cost Breakdown as a template for invoices submftted 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 identify 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 preven don device are eligible for City rebate and therefore should be included on the upper half of this form. Additional costs may b LaddedAbottom of the form. Business Name: c.an Se,�t2JP1!"' License Number; A6,oksMT_ Business Mailing Address: > 2,367t �' �•�f�M[D 5 _ �' a o� Phone: 2Db -q5% Li 1Q3 Category Description Units Quantity Rate Total Administration Administration / management Hours Labor CCTV Inspection -Hours BWV Install Hours O Pipe replacement Hours Surface restoration Hours Site cleanup Hours Downspouts / drainage imp. Hours Materials Backwater valve Per Unit Dt DD FO Grinder pump Per Unit Side sewer pipe (up to 8 feet) Feet Imported Backfill Yards Surface Restoration Materials to sail, ra concr eed ete etc. Lump sum y 1� 1 5,00 00 Cover rdgation bo earing cover Per Unit D•� OO Rentals Specify equipment Hour Fees Disposal fees byitem Yards p,00 .O Delivery fees if not covered by labor o a00 Eligible Total Other Costs Costs not associated with BWD, and not ell ible for rebate detail below p4 a iu LA 1411— Ineligible Total S ,o l9 rs Total $ Revised 910312014