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CITY OF EVERETT <br />Utilities Division WO• No• <br />MATERIALS <br />Sub Total Material Cast $ <br />Total Material Cost $ <br />LACVNANV tV UIYMCIVI Vry r'HVJQUI <br />NAME OF WORKERS HOURS I RATE COST EQUIPMENT HOURS I RATE COST <br />Sub Total Labor Cost $ Sub Total Rental Cost $ <br />Total Labor Cost $ Total Rental Cost $ <br />V�/ (2 Total Charges, Materials, Labor and Rentals $ <br />Date Work Completed: / --- <br />Signature of Foreman:f3-� <br />COMMENTS <br />