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\ ~ 1 r, ~ ~ ~ ~ ~ INVOICE NUMBER <br /> ` EMPIRE ~ - <br /> CONCRETE <br /> CUTTING tNC <br /> 1484 CHEEK STREET SPRINGFIELD, OREGON 97477 <br /> FAX: (541) 746-1149 CCB# 51754 <br /> (541) 746-8818 <br /> f <br /> ~ -~g_~=` ' ~ ~ Day Date ,r . <br /> ~ ~ r'• <br /> - <br /> / ' <br /> P.O. No. <br /> Job No. ~~~'s., irk <br /> Job Address t +~~r.~.~• ~ Operator ~ t C. t.' <br /> QUANTITY ~,~(U D E S C R I P TrI O N PRICE AMOUNT <br /> X fi <br /> ~ 'F ~ j . y, 1~ <br /> / L!'_ ! v; ,`c'am <br /> i ~ L..- <br /> <br /> ; / <br /> 6 j~-2)-U0 r u~JU IiJ <br /> 7 <br /> - 8 QB~B (7 <br /> ~..a To: <br /> _ <br /> 9 ~ COtlt[' M0. <br /> EXTRA'S -CHARGE ORDERS -STAND BY TIME <br /> 1 ~ i1SlUre D <br /> 12 <br /> y We do noft3assf~me responsibility for damage' cau~ei~. by F,,utting buried Y ` ~ <br /> ti ~ ` <br /> pipe, conduit, voids, steel beams, water damage, percussion damage, <br /> - . <br /> or asbestos abatement. <br /> The undersigned hereby understands -and agrees to Empire - • _ _ ' • ' • ' ' <br /> Concrete Cutting credit conditions as follows: <br /> 1.8ills due and payable 10th of month following date of purchase. . . , • • • • . • - <br /> 2. Past due bills charge at 2% interest per month. <br /> 3. Should ECC institute collection on this account, I will pay reasonable attorney <br /> fees and costs incurred in the pursuit of colection, including court costs. <br /> SIGNATURE <br /> <br />