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HomeMy WebLinkAboutASB form.pdfity of ° ,toC�n S CITY OF RENTON AUTHORIZATION OF SPECIAL BILLING January 6, 2016 William Gustayson EE -NA Enterprises LLC 12345 Lake City Way NE i#2 Seattle, WA 98125 015002905 — Blakey Towhomes Account # 3760 It is the intent of this letter to authorize the City of Renton to bill the undersigned for ail costs incurred relative to the referenced project, by the City of Renton for the following work: • TIME AND MATERIALS FOR ANY AND ALL ROAD CLEANUP EFFORTS PERFORMED BY CITY FORCES OR CITY CONTRACT. • ALL OVERTIME FOR INSPECTION AND RELATED ACTIVITIES, BILLABLE AT A RATE OF SEVENTY FIVE DOLLARS ($75.00) AN HOUR. • TIME AND MATERIAL FOR ANY WORK DONE BY CITY STAFF TO REPAIR DAMAGES. • TIME AND MATERIAL COSTS INCURRED FOR SECONDARY, INDEPENDENT ENGINEERING REVIEWS, CONSULTATION AND ON-SITE INSPECTIONS AS DEEMED NECESSARY BY THE CITY. BILLING TO BE SENT TO: (Print Please) Name: _/ _��i t1,1 v$ l %-/9C `J Company: Address: a2S— Phone: Fax: 4�;61 3c( 844 \ l-? -1_ Date