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1 1 1 1 1/ INVOICE NUMBER <br /> ' EMPIRE . - - ; <br /> CONCRETE ' I <br /> CUTTING INC <br /> 1484 CHEEK STREET SPRINGFIELD, OREGON 97477 <br /> (541) 74&8818 FAX: (541) 746-1149 CCB# 51754 , <br /> TO r ~ ~ Day L~~: f,~ ~ Date <br /> ~49 <br /> P.O. No. <br /> Job No. <br /> i' i ~t <br /> Job Address ,y ~~r' ~..v Operator i r ~ 61 ~ <br /> T -s <br /> QUANTITY D E S C Rrl P T I O N PRICE AMOUNT <br /> t <br /> - <br /> ~ L <br /> 3 ~ ; <br /> <4 <br /> 5 Dc~C ~'TiGN ~ ~ ~ 20 <br /> 6 ACCOUNT CODE ACCOUNT AMOUNT 2 <br /> ~ _ - 12 2 7 0 5 <br /> - , <br /> S <br /> ~8 D e ~ D <br /> s To: ' <br /> 1 D EXTRA'S -CHARGE ORDERS -STAND BY TIME SIGNATURE ^ ~ <br /> LtR'Y O <br /> 11 ~ I approve for <br /> 1 z Si~ttatui~e Date: <br /> We do n~ assume responsibility' fbr da~rrtage caUs~d by'~utting buried , c • <br /> <br /> pipe, conduit, voids, steel beams, water damage, percussion damage, <br /> or asbestos abatement. • ' • ' <br /> <br /> The undersigned hereby understands and agrees to. Empire • • • • • ' • • ' • - <br /> Concrete Cutting credit conditions as follows: ' ' ' • • ' • ' <br /> 1. Bills due and payable 10th of month following date of purchase. • . . , • • . <br /> <br /> 2. Past due bills charge at 2% interest per month. <br /> <br /> 3. Should ECC institute collection on this account, I will pay reasonable attorney ' , . ~ ; J - <br /> fees and costs incurred in the pursuit of collection, including court costs. n I;t,C~t `~~r <br /> fir' y ~i.) <br /> GNATU <br /> _ SI E ~ <br /> <br />