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Requeat for Billing �nsiza�z <br /> Cost worksheet <br /> To: Finance Department <br /> From : Street Departmant <br /> 1613 Baker Ave � Bill to: Gerald Dallman <br /> Date of Service: 07/25N 2 1813 Baker Ave <br /> � , . • , - �� , .:,. . <br /> ' " , EvereN, WA 98201 <br /> Description of work performed <br /> Contact P�non: <br /> Sidewalk Replacement stn�t D.pt Sup�rvlsor <br /> +';_i:. _. ... ,:.� ..,�.,..<;, <br /> W/O# 201:1898 * <br /> .. .ty,or'\'S§..���.� .�,, .� � `• ��° . , ' . " , . <br /> Labor $0.00 <br /> Benefits (29% of Labor) a0.00 <br /> Sub Total for Labor :0.00 <br /> Total Labor $0.00 <br /> Materials a0.00 <br /> N/A Materials (Concrete 4 yards � 87.75 pedyd) $351.00 <br /> Equipment a0.00 <br /> Sub Total :361.00 <br /> � , � �x � .���. <br /> , . i.,;,- <br /> . . � <br /> Balance Due i361.00 <br /> , <br /> : 5; ,,_� . .��r. � <br /> DR-120-1220000000 � ` <br /> CR-120-3699000000 <br /> CR-120-1220 0000 � <br /> Si ned: <br /> Approved: <br /> e , �as�s�n co o nvoic�to tt • m <br /> costworksheetlexceVcpm <br />