1921 MCDOUGALL AVE 2022-05-03 - Laserfiche WebLink

BACKWATER PREVENTION PROGRAM 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'ollowing line items can be submitted. This allows you to invoice your client according to your existing billing template while allowing city staff to identify flow 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:Ayflr-oCC2lo ;ter p6—c 51t IP License Number: Business Mailing Address: aRkz : Larkin OIL ;l%r't'�.it% City State Zip Phone: 7la' xfr� -�Yl�'a Email:c .fr irtor City � � riE6_Zip Cc� Categ� Administration Description Administration / management Units Hours Quanti Rate Total Labor CGTV Inspection Hours BWV Install Hours Pipe replacement Hours Surface restoration Hours I- aCD Site cleanup Hours Downspouts / drainage imp. Hours Materials_ Backwater valve Per UniI - Grinder pump Side sewer pipe (up to 8 feet) Per Unit Feet _ Imported Backfill Yards Surface Restoration Materials _(Lop soil grass seed concrete, etc.) Cover (irrigation box or load bearing cover Lump sum Per Unit 2✓� —) Rentals Specify equipment Hour Fees _ _ DisposoI fees by item Yards /l'•1��'' Delivery fees if not covered by labor Eligible Total Other Costs Co is not associated with BVID, and not ell ible for rebate detail below al, I-V c cfrr vt Hzgj Ineligible Total $ IS Total $ -b ' Revised 910312014