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0\1 11//1 <br />(5 <br />INVOICE NUMBER <br />Day Date , 9,s <br />1 <br />P.O. No. <br />EMRIRE ~bl~'~~aas`~ <br />_ <br />CONCRETE <br />CUTTING INC <br />1484 CHEEK STREET SPRINGFIELD, OREGON 97477 <br />FAX: (541) 746_1149 !`CB# 5175 <br />1 <br />~ <br />Job Address_ <br />Job No. <br />I J# <br />Operator.' <br />QUANTITY <br />' D E S C R I P T I O N <br />PRICE <br />AMOUNT <br />2 <br />( <br />3 <br />4 <br />5 <br />6 <br />s <br />10 <br />EXTRA'S - CHARGE ORDERS - STAND ey TIME SIGNATURE <br />11 <br />12 <br />Vile do not assume responsibility for damage caused by cutting buried <br />a. <br />pipe, conduit, voids, steel-beams; water damage, percussion damage, <br />or asbestos abatement. This will acknowledge receipt above services as <br />Tho undersigned hereby understands and agrees to :Empire • • - • ' • • • • ' ' • - <br />in the event in this are <br />Condrete Gutting credit conditions. as follows: the prices stated agreement " ' p <br />1. Bills due and payable 1 Oth.ot. month following date of purchase. Covering . and _ openings responsibilit <br />• date of this ticket. <br />- • - • - <br />. due. <br />aid - <br />y <br />L. raoL uutl uma WIQI y{7 00. c 70 1I I W I CAl pei n IVI Ill I. <br />