|
1_�c_41_uuN lxu_ur1uN tl.U1WANx l—JrrµoL`y 1 l
<br />d. Strael Addtost 7. Field Oil.,. (Ca, only) B. Old., Flo. 9, Uolo ,
<br />1
<br />82LCenter_Ron Seattle 10914 12-13..73
<br />5. City b. Ste lc Zip Code 10. Uacuum Inrm+ 11. hme for Uelivafy
<br />.erett ashington82_ et I 25_days /7H
<br />Sub(ael Io e011Jo.u"s wn't.d n the rev arse uJe huru ul, you ra h... by r.q out led d .0......J to pc r for n en sc,-c" m I/or dub.er the articles
<br />below (ar on clenched) utc.,dim, t. let all of your quaulian, The adonnalion Indicaled in .1,ms 7, B, .nJ 4 n•ml uppum un all yu nt, papsfy
<br />comes and an, v, etc., relating to Chit Unnsnclion,
<br />12. Ofdewf by 1'11U0• or 11n14er's X111119 Ued Addll>l) 13. Ey1WQnee'r Ii drTb nl p lulrell)'_llprnf rY'f U//Ire)
<br />DANARD & ASSOCIATES, Inc. 7808 Beverly Boulevard Everett
<br />IJ Sipnotvm IiTJII.--�-"
<br />P. O. Box 807 / %�
<br />) � P Y g
<br />Everett, Washington 9g2� �� ..6/ P o art Manager
<br />ash gt --•
<br />ib, AU1l HakiiJ J L( -- Sipe.: lilt,, Vale
<br />aHklcyt[rvllcn orYdefad by Oroker)s Realty Specialist 1Z1j
<br />IZ'
<br />Is. Arlidetand/or Survives
<br />19.
<br />Unit Price
<br />22.
<br />I'em
<br />tlo.
<br />Ill this Information Is munssced on bid specifications. onad+ a
<br />copy and typo below'If I ACCORDANCE Willi AIIACHED•l
<br />caun•
<br />lily
<br />Amount'.
<br />20.
<br />21.
<br />Cost
<br />Par
<br />561—le4324-2o3
<br />$
<br />s
<br />In accordance with attached Management -Broker's
<br />Specifications: Obtain all permits; demolish all
<br />structures, including structure and debris at
<br />rear of property; haul away all debris; grade the
<br />lot level with adjacent terrain and seed with grass
<br />seed, per amount of bid......
<br />700.00
<br />It ahova spat. TnsulHO.O..S. Purchuso Order and I'aymmnt Avthorlrvliamt untinuolion Sheet,
<br />TOTAL—TNCLUDINO
<br />Fill. r.,.,l I
<br />CONTINUATION SHEETS
<br />S 700e00
<br />22a4AIIAGi 1AEIIT BROKER'S COEIFICAIION (!F APPLICA011) ----
<br />gob Completed
<br />1 cenily that I (or my reprewnlalive) personally inspwclud [his properly and Ia the
<br />Signature
<br />best al my knoal.dge and belief all specilicallons have been met and all .Pat,,
<br />hove been ends and payment Therefor hoe not hvrulolore been mode.
<br />24. CIHCF PROPERTY OFFICER'S (OR DESIGNEE'S( CERIIFIC A11011
<br />Dole Completed Payment Approved For ❑ Acceptance of brats r't Inipurron
<br />$ on baits of Jr► ❑ Farm 9519 Inspection Report
<br />Signature Tills Dole
<br />Realty_ Specialist_ _
<br />25. AUTHORIZED CERIP r ,
<br />vaned In mw, ice ally emt This Signobre ..n ..�,n I Crrnlring Officer's Stomp
<br />Pufcuunl IAOlder
<br />PmO .ad
<br />chusa rdar and Paym ant Aulhnr is noun is cornxl
<br />and proper Tor Vuym ant.
<br />DO NOT USE SPACES BELOW THIS LINE
<br />Amount Su:Vruded
<br />Am ... I V.01.J Carr.rt for Pa,,n.nl
<br />(&r Aftmhed)
<br />$
<br />(Sill n..1"" nr Inlliah)
<br />s
<br />Acwuramg uussihennon
<br />WAFINING: Section 1010, Title 18, U.S.C., "Uepslrbumlt of IlousieU and Urban Duvnl.
<br />opntenl and Federal Housing Adndaistration llansaclinns.-pruvidus: "Whoever. let
<br />ilia purpose of ... influencing in any Way ilia action of stich Duparnnanl ...'Flakes,
<br />passes, ulties, or p iblishus any statement. knowing the same to be false ... Shall
<br />he lined nnl mnra than S5.000 or itnithisoned not more titan Ewe ynes, or bell,, '
<br />east 1.1, J11— I um t.nnydi ofLr!DIVERSIFIED PAYMENTS BRANCH COPY,r InpmeM lu Li: r .i. .. r 4
<br />_. . nUUK: G Pall.
<br />ID Number or
<br />THIS BID COVERS FOLLOWING ITEMS: Social Security No.
<br />1 ,
<br />1,
<br />Demolition per above specifications ADDRESS:
<br />DATE:
<br />PHONE:
<br />7
<br />
|