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1910 MCDOUGALL AVE 2022-05-03
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1910 MCDOUGALL AVE 2022-05-03
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Last modified
5/3/2022 8:00:45 AM
Creation date
5/3/2022 8:00:02 AM
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Address Document
Street Name
MCDOUGALL AVE
Street Number
1910
Notes
BACKWATER VALVE
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BACKWATER PREVENTION PROGRAM <br />INVOICE COST BREAKDOWN <br />Please use this Invoice Cost Breakdown as a template for invoices submitted as part of the Backwater <br />Prevention Device rebate program. Either this form or your own invoice form with the following line items can <br />be submitted. This allows you to invoice your client according to your existing billing template while allowing <br />city staff to identify how costs eligible for the Backwater Prevention Device Rebate were accrued. <br />Only labor and materials directly related to the installation and function of a backwater prevention <br />device are eligible for City rebate and therefore should be included on the upper half of this form. <br />Additional costs may be added to bottom of the form. <br />Business Name;„J){ rG` fir! �2 License Number. s <br />Business Mailing Address: <br />Zip <br />Phone:2-y 0 <br />Catenory <br />escri tion <br />Units <br />Quanti <br />Rate <br />Total <br />Administration <br />Administration I management <br />Hours <br />Labor <br />CCTV Inspection <br />Hours <br />BWV Install <br />Hours <br />Pipe replacement <br />Hours <br />_ <br />Surface restoration <br />Hours <br />Site cleanup <br />Hours <br />Downspouts / drainage imp. <br />Hours <br />Materials <br />Backwatervalve <br />Per Unit <br />Grinder pump <br />Per Unit <br />_ <br />Side sswer pipe (up to B feet) <br />Feet <br />rr n <br />Imported Backfill <br />Yards <br />Rentals <br />Surface Restoration Materials <br />to soil, grass seed concrete, etc.) <br />Cover (irrigation box or load bearing <br />cover <br />Specify equipment <br />Lump <br />sum <br />Per Unit <br />Hour <br />a <br />Fees <br />Disposal fees by item <br />Yards <br />I' <br />Delivery fees if not covered by labor <br />_ <br />Eli Ible Total <br />�" <br />$ <br />Other Costs <br />Costs not associated with BWD, and <br />not eligible for rebate (detail below <br />Ineligible Total <br />Total <br />— <br />-- <br />11DO • ,Z_ <br />rk'i�T �D el-" <br />I -%- IS <br />Revised 910312014 <br />
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