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/.n/1 ~ U..L.~ r <br /> 7C~Y~~ n~`: f f <br /> ONCRETE ~ <br /> CUTTING INC ~ ~ A~.. <br /> i 1484 CHEEK STREET SPRINGFIELD, OREGON 97477 <br /> (541) 74~-8818 ~ FAX: (541) 746-1149 CCB# 51754 <br /> ; -r' Y Vl ~ Date _ a <br /> <br /> ~ <br /> i ' Job No. <br /> Job Address ~ w fir ? ~ '~13~ ~i ~''~~t~ ~1~"? Operator,+ ~ ~ ~ ~ <br /> i. <br /> QUANTITY DESCRIPTION PRICE AMOUNT <br /> 1 r~ t~ ' ~ it , ~ <br /> e. ~ <br /> . <br /> 4 t ~ ~ f <br /> i. <br /> 5 r~ j <br /> 6 <br /> 7~ ~ ~ d0~ ~ <br /> t~ ~ <br /> i <br /> 8 ~ « ®UE <br /> s ,fob ~ a N© h ~ <br /> 10 exTRn•s SIGNATURE V <br /> 12 <br /> 06-07-07 P12~0 IN <br /> We do not assume responsibility for damage caused by cutting buried ~ , <br /> pipe, conduit, voids, steel beams, water damage, percussion damage, ~ ' <br /> or asbestos abatement. - • - • <br /> The undersigned hereby understands and agrees to Empire <br /> Goncrete Gutting. credit conditiotu as follows: ' • <br /> 1. Bills due and payable 10th of month following date of purchase. • _ • <br /> 2. Past due bills charge at 2% interest per month. 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. ~ r" ~_t~! <br /> F„~ ~ - <br /> SIGNATURE <br /> <br />