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v M <br /> ' ~ \ 1 1 I I 1 / ~ INVOICE NUMBER <br /> ` ' EMPIRE <br /> CONCRETE x'' <br /> CUTTING INC <br /> 1484 CHEEK STREET SPRINGFIELD, OREGON 97477 <br /> (541) 746-8818 FAX: (541) 746-1149 CCB# 51754 ~ <br /> TO ~ ~ ; ; ~ ~ ~ x. ,r,. cr,.~-..~ Day ~Y ~ ~!'v~t(~ i;~ Date ~ ,1 ~ ' 4~ <br /> -I--~`r-~-~ <br /> ~{`a'~ ~,rr>~~~ Job No. - r ~'f~ , e ~ <br /> ~'~.o T ~ t~~ <br /> ~ ; <br /> Job Address ~ i ! ~ ~ < < ~ ~ f ~~i ; r' t i:~ ~-"''"1 <br /> ~~~~1~ Operator + • ; r <br /> QUANTITY DESCRIPTION PRICE AMOUNT <br /> 2 <br /> i ` <br /> 5 `"1 C: 1 to ! ~ ~~7 _ <br /> 6 ~ ~ <br /> ~ f 1 <br /> ~ R~\`~ <br /> EXTRA'S -CHARGE ORDERS -STAND ~Y TIME ' S ATURE <br /> 10 <br /> - / <br /> 12 ~ ~ <br /> We do ssume responsibility for.damage caused by cutting buried aC~• <br /> pipe, c it, voids, steel beams, water damage, percussion damage, <br /> or as s abatement. ~ ~ ' ' <br /> . <br /> The u ersigned hereby understands and agrees to Empire - • • • • • • • - - • • • <br /> Concrete Cutting credit conditions as follows: ' • • " • <br /> 1. Bifls due and payable 10th of month following date of purchase. • • • <br /> 2. Past due bills charge at 2% interest per month. <br /> <br /> i <br /> 3. Should ECC institute collection on this account, I will pay reasonable attorney <br /> fees and costs incurred in the pursuit of collection, including court costs. <br /> SIGNATURE <br /> <br /> i <br /> <br />