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CITY OF EVERETT <br /> REFUND AUTHORIZATION <br /> T0: Cily Treasurer DATE: February 4, 2015 <br /> You are hereby authorized to refund the following: <br /> PAYEE ADT Attn: �im Nickols <br /> & 6102 N 9`�'St, Suite 700 <br /> ADDRESS: Tacorna, WA 98406 <br /> AMOUNT: $ 24.00 <br /> REASON: Work not performed <br /> GL CODE: 002-322-1101-831: <br /> 002-322-1500-831: 1NVOICE #F.E31d10-019 <br /> 002-322-1300-831: (Flease prinl Ihis number nn the refund check) <br /> 002-322-1200-831: 512.00 - <br /> 002-322-4011-831: <br /> 40�-343-50-109-460-00: <br /> 401-343-50-109-460-14: <br /> 401-343-40-119-471-02: <br /> 002-345-8300-631: <br /> This amount was received by the City oF Everett on 10/7_0/2014 8 10/14/2014 and recorded on permit numbers <br /> E61410-019 & EB1410-014. � ,/� �f ��,/ <br /> I ;1 `G V-c��� <br /> February 4_2015 _ �- �����/"." -- --- - <br /> - -- '-- (tlate) (Aulhonzed S�gnalwe) <br /> Paul McKee-Permit Services Manager <br /> �r�— - ------ <br /> Refund by Check No. Date <br /> _Original Receipt Attached <br /> Account Debited: __ <br /> Or refund noted on Treasurer's O�ce Copy. <br />