Laserfiche WebLink
1 <br /> 477 BACKWATER PREVENTION PROGRAM <br /> INVOICE COST BREAKDOWN <br /> i <br /> Please use this Invoice Cost Breakdown as a template for invoices submitted as part of the Backwater <br /> Prevention Device rebate program. Either this form or your own invoice form with the following line items can <br /> be submitted.This allows you to invoice your client according to your existing billing template while allowing <br /> city staff to identify how costs eligible for the Backwater Prevention Device Rebate were accrued. <br /> Only labor and materials directly related to the installation and function of a backwater prevention <br /> device are eligible for City rebate and therefore should be included on the upper half of this form. <br /> Additional costs may b added to bottom of the form. <br /> � rr Ivor--tf► tI c ` l D is <br /> Business Name: �AJ L DYI��'"� License Number: <br /> Business Mailing Address: -Fa Fox 1 -z-/ ` fes AA- - 9 + z_ <br /> City State Zip <br /> Phone: Email: <br /> Category Description Units Quantity Rate Total {' <br /> Administration Administration)management Hours <br /> Labor CCTV Inspection Hours <br /> BWV Install Hours t tt-f �I11`2i <br /> +l ji <br /> Pipe replacement Hours ,5 c S (G`5 a r 5 O <br /> Surface restoration Hours a Co 5" 13r) <br /> Site cleanup Hours 3 lo 3 '1 <br /> Downspouts/drainage imp. Hours _ <br /> Materials Backwater valve Per Unit 1 . 5*-0 ` 2.50 <br /> Grinder pump Per Unit <br /> Side sewer pipe(up to 8 feet) Feet _ 5j _ L��j"'� 3410 _ <br /> Imported Backfill Yards <br /> Surface Restoration Materials Lump <br /> (top soil,grass seed,concrete,etc.) sum <br /> Cover(irrigation box or load bearing Per Unit <br /> cover) <br /> Rentals Specify equipment Hour <br /> Fees Disposal fees by item Yards <br /> Delivery fees if not covered by labor is <br /> Eligible Total $a9441,542 <br /> Other Costs Costs not associated with BIND,and <br /> not eligible for rebate(detail below) <br /> Ineligible Total $ _ <br /> Total $ , X11,$`U� <br /> is <br /> 0 k, fop conittfz'r <br /> tAh1 <br /> v k 0'3433 <br /> Revised 9/03/2014 <br /> - , aLII? 3 <br />