3522 OAKES AVE 2022-05-04 - 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. Eitherthis 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 half o phis nt ion device are eligible for City rebate and therefore should be included on the upper Additional costs may be added to bottom of the form. Business Name:4}ye��E� ��P License Number: — Business Mailing Address: Zip Phone:S EmaiCC_ r°In ��C�n,S� �/1d 5�i1 �r C'cSYYI ��r�_-r�2 Cate a Deseri Lion Units Quantity Rate Total Administration Administration / management Hours Labor CCTV Inspection Hours LSD BWV Install Hours Pipe replacement Hours — Surface restoration Hours Site cleanup Hours Downspouts / drainage imp. Hours Materials Backwater valve Per Unit Grinder pump Per Unit Side sewer pipe (up to B feet) Imported Back"" Surface Restoration Materials Feel Yards Lump aC7 to soil rass seed, concrete etc. sum Cover (irrigation box or load bearing Per Unil cover) Specify equi pent Hour Rentals --r-4z A�133 Fees Disposnl fees by item Yards Delivery fees if not covered by labor Eli ible Total Costs not associated With BWU, and Other Costs not eligible for rebate detail below -- G f� Ip a�_ cvnkh ftclru/ yam- p11 f $10 A 111— Firieligible Total 1_ $ Total Revised 910312014