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f ' CITY OF EVERETT <br />Utilities Division W�• NO• '� y�' � <br />Sub Total Material Cost 5 <br />Tolal Material Cost S <br />Sub Total Labor Cost $ Sub Total Rental Cost S <br />Total Labor Cost S Total tiental Cost S . <br />j2 3/� � Total Charges, Malerials, Labor and Rentals 3 <br />Date WorA Completed: � <br />Signature of Foreman <br />COMMENTS: �vX /�0�� � 1, � /lP� <br />b Z�' "�fi� <br />0 <br />