|
FHA FORM NO. 2542 Rev. 5/72
<br />'[J. 5 DEPARTUEN�yF HOUSING AND URBAN DEVELOPUENT is't1LT1AL MOUSING ADMINISTRATION Imbudiom to Field 011ics[: For payment conlroclor COMPTROLLER'S
<br />mw by Treasury checkforward Ports 1, 2, and 3 to Office al USE ONLY
<br />PURCHASE ORDER AND The Comptroller. For payment from r..let Income,Man,I.BureauVoucherNo.
<br />PAYMENT AUTHORIZATION agemen, Agent will transmit Par, Iwishariganal uccounling report and Parts 2 and 3 with duplica,e and tr ccou t.RvfS,z 11.1 Expnu,n On Aryuired PrnprrYMA report Copies. Sea Vol. V, Sec. 6, FHA Manual, 1., 2. Bureou Schedule No.
<br />See H.11431aS, 4:)I S. 1. and 4A_l1.Idetailed Instruction,.
<br />Conlrudr and Payee
<br />M&G SALES & CONSTRUCTIONPayees Account Na. Name fon,rol Rpl. Code
<br />.00t Address 91-0897030
<br />P. 0. Box 220
<br />7. Field 011ice (Cily only) 8. Order No. 9. Dole
<br />Seattle
<br />5. CH, 6. Stara 10272 11-26.73 Zip Code 10. Discount farms I I. Time fur Delivery Everett Was hin on 8206 Net
<br />$ubiocl ,0 conditions printed on ,he reverse sidu Luruoi 15 d $ Lulow (ar on attached) a,cordin to terms of y°V are hereby reyuesled and author), ad to p.,lorm the services and/or deliver the wtwas
<br />,mrospondence, at,., ,efoling to ,h ii Irantoclionyuur quolalion, the information Indicated In )rums 7, B, and 9 must ap
<br />pear on ail packages, papers,
<br />11. Ordoied By r."D' or Orolzrr'e Numr Will Address) 13. Conti n
<br />DANARD & ASSOCIATES Inc. 7 ee (Abaree uJ Eve a prn, u/sh
<br />P. 0e Box 807 ' 3428 Lombard -Everett, Washington
<br />4. >,gnaw,u
<br />Everett, Washington 98206 s. rur
<br />j 16. AUTHORIZED BY Sig"'... - Property Manager I
<br />/For car,. 1clim by Ficld O//ice rv4ea "� r lulu
<br />nrr/clC;hcrulees ordcrrd by 11,,oker) Da
<br />r 17, alty Specialist
<br />It III this 18. Arllde and/or Sorvices 19. f
<br />s Informmlon is Itemized on bid speofi,alions. attach a Unit PrI,o 22
<br />too. copy and typo below -IN ACCORDANCE WITH ATTACHED-) Conn.
<br />lily 20. 21. Amount
<br />" Cost per r
<br />561-146412-203 $
<br />III
<br />Demolition per management -broker's specifications of I
<br />11-20-73
<br />885.00
<br />i
<br />i f
<br />II above space inwlfictenhuse Purchase Order and Payment qulhoritollom Con,inuo,Ion $heal,
<br />FHA Form 2542A. TOTAL —INCLUDING
<br />23.MANAGE/.LENT BROKER'S CERTIFICATION JIF APPLICAOLEONTINUATION SHEETS 6885.00
<br />Data Completed I cerllly Thal I (or my r oprose.i.ii,ai pursonally impacted This properly and to Iho
<br />best of my knowledge and belief all tpedlications have been mvl and all rvpoin Signoruro --
<br />hove been made and payment therefor ha, not heretofore bran made. I
<br />2CHIEF PROPERTY OFFICER'S (OR DESIGNEE'S)
<br />mCERIIF ICAfION t
<br />Dole Completed Payent Approved Ford, II
<br />❑ Acceptance of Broker's Inspection I
<br />Signature $ on basis of ___Jr� Form 9519 Inspection Report
<br />Tale
<br />Realty S eoialist D°I°
<br />25. AUTHORIZED CERTIFYING OFFICER'S CE RTF ICAIIOrk
<br />Pv„uonl ,o authority rafted in me, 1 ce rlily ihel this
<br />Parch oto Order end Payment Aulhorizalion Ix correct Signature Authorized Certifying and proper for payment. 9 officer-, Stamp
<br />Amount Suspended �� DO NOT USE SPACES BElO1V THIS LINE
<br />Amount Varllied Corre<I tar Payment
<br />/Sre Atmr6rdl $
<br />AC,oanling Clvuili<alion ISiRrmOrrv• ur 1nilialA) 5
<br />WARNING: Section 1010, Title 18, U.S.C„ "Department of Housing and Urban Devel-
<br />opment and Federal Housing Administration Transactions,"provides: "Whoever, for
<br />file purpose of ... il:Iluencing in any way the action of such Department ... rnakes, 11
<br />passes, utters, or Fi:!)IisheS Oily statement, knowing the S„tno 10 be false ... shall —.
<br />be tined not more than S5.000 or imprisoned not more than two Years, or bull,.' -
<br />PART 1 . I; s.il �,u el Thu Cain ldndhu IDIVEDSIFIED PAYMENT BRANCH COPY I .�
<br />". _ •I n r Poymen) lu L°
<br />mr.m I. L...r,e ,hu•A
<br />
|