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. . PClil.l�4YORf:S DLP:\R7\IIiST <br /> Ulili:ics Ui��ision,3200 Cedar Slrcel <br /> EY GccmIU�VA 98201 <br /> -I?�-2�7-5300 <br /> �� <br /> I�eceipt if Datc I'ai�l <br /> Cost of Work Order Work Ordcr� <br /> ✓ Cost of Service Order ..�.6�32�1:98' G�����vice Order# <br /> Contact Person Tclephonc# <br /> Rcqucsted f3y Kirl<Brooks Dale of Request 09-28-07 <br /> Property Owncr(namc) Community Health Center <br /> Charge Cost to(namc i[dif(crent Ihan oi��ner) <br /> Address 5929 Evergreen Way, Suite 200 Citv Everett, WA _ z�p 98203 <br /> Installation Locntion 8609 Evergreen Way <br /> Installation type/descriplion/sizc/ctc. 6" tire service expose 12" in Evergreen make hot tap, trench/ <br /> excavate install pipe vault and set DCDA in vault Make final connection after testing and purity. <br /> (] The following estimate is Uased upon the Utilitics Division providing all labor,ec�uipment, <br /> materials,restoration,and final hook-up. <br /> I'IeiSe notify the Citv of Gverett Utilities Division 10 workine davs in advancc of re��ired installation <br /> d�te to �llow for schedulin�and parts Dracurement <br /> {Vhenever the estimaled cost is not sufficient to cover the total expense for I�bor, material, eqwpment renlal and <br /> administrative msts, tlie deficit sliall Ue charged to the property for which such installation ieas made and the <br /> uwner thercof, and provided furtheq that any excess payment shall bc mturned to thc person applying fur thc <br /> installation. <br /> *Deposit nnist be paid prior to ordcring parts or scheduling worlc. <br /> WATGP. i�lL-lC1:S 3"rl ND L�IP.GLP. ,19f1Y II�I��E A SI�A' TO 10 i��"CLK LL-'flD 'TL,��I�. <br /> ce I�Idg. Pcrmil Cenler <br /> $#*56:00� �]�rk�,�dlcr <br /> \t;i��ri:il y�v iCirkl3rooks <br /> L:ibor and 13cncfits �,$32:80� ��� Gordott Witchcr <br /> Robcrt Waddlc <br /> Equipment Rental .-��Q �� Mall Wclburn <br /> � 283.00 ��'J� Benyam Slephanu; <br /> T��� �----� Ccrry Cnmi <br /> 7'O'CAI. �� 16,421.00 //� Dennis Robcrson <br /> , ^ ^ Cliff Lindman <br /> U�� /;, Randy All�n <br /> u ,, <br /> , <br /> , . <br /> Pr�p:ucd b�•: Gerr Crum atc Gstimatc Prepared 10-01-07 <br /> :lcccpt�d by: Rcpresentin� <br /> IiSTIAL�TI:COOD POR 6 DION'1'll <br /> ,�.,.r.�_.� ..I:u.aMnaa�B(1�GapnrnN'ay.UOC �_U� _�_ I L�: <br /> ��1� <br />