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Request for Billing 4/17I2012 <br /> Cost worksheet <br /> To: Finance Department <br /> From : Street Departm�nt <br /> :cca:..:�:.::ss:c:'.:::r...i:_.- <br /> 1823 Lombard Ave Bill to: Laina Brown <br /> Date of Service: 04/11/12 3501 Hoyt Ave <br /> ""�'"`�''''='���""'~ ` Everett, WA 98201 <br /> Description of work performed: <br /> Contact Person : <br /> Sidewalk Replacement street oept supervisor <br /> Mike Hale 425 257-8835 <br /> W/O# 20120565 <br /> Labor $�.00 <br /> Benefits (29% of Labor) �0.00 <br /> Sub Total for Labor $0.00 <br /> Total Labor $0.00 <br /> Materials $0.00 <br /> N/A Materials (Concrete 3 yards @ 87.75 per/yd) $26325 <br /> Equipment $�.00 <br /> Sub Total $263.25 <br /> � � <br /> , y �� ".r � <br /> .� a;.. ,,. . . , . , .,_ <br /> - - $26:3.25 <br /> Balance Due � � , <br /> ����. , _ . . _ ,- ` <br /> DR-120-1220000000 <br /> C R-120-3699000000 <br />- -, CR-120-1220 0000 � <br /> � Signed: \' �- I <br /> Approved: <br /> Jeff please send copy of invoice to Matt Welborn � <br /> costworksheeUexcellcpm <br />