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FORWARD, INC. <br /> 1145 VN/e5t Charter WayINVOICE <br /> Stockton,CA 95206 Invoice Date 1 1/301201 7 <br /> REPUBLIC Cust ce No 44-442204a0011Y33i 7 <br /> SFAS <br /> IL2RSTL,DTT =173 Page No 1 of 2 <br /> rrlr�l.11�'1'��'11'��'�Irrrrlllrr'.rlrlrl'I'rrir.rlrrlrllrlylrrr Due Date 12130/2017 <br /> H&H ENGINEERING CONSTRUCTION <br /> MARIA JAIMES Current Charges Total Amount Due <br /> 212 INDUSTRIAL DRIVE :657.E3 _ L---- g•gg <br /> STOCKTON,CA 95206 <br /> Please Pay Total Amount Due <br /> 13illiN Questions?Cali 209-466-UE12 <br /> IMPMTANTIEP To ensure yaw payment is posted to the correct invoice,we need <br /> Ow torn remittance from your invoice.Thank you. <br /> r — <br /> Dane Cale DesaWm <br /> ---I 11127 VS Vila-!iT BER n;tEATED/0L0 0/ �7/�y�y GO Cn ---- 7 �p�Iyt <br /> O 7 S 12749 9 58.50 9.IJ5 i N- 585.00 <br /> :j 11127 VS Reference:4297818 <br /> 0 <br /> 11/27 VS VeN de.- DGC 3364,DCC 40YD <br /> 11/27 VS Contract 4204122008 <br /> Z 11/27 VS Generator Name. H&H ENGINEERING <br /> z 11/27 {1 ENVIRONMENTAL FEE 1 16.25 <br /> Z SC7i3462 16.25 1.00 <br /> z { 16.25/Ticket)ENVIRONMENTAL FEE 1 <br /> z 11/27 )1 FUEL RECOVERY FEE SC713463 37.03 1.00 37.03 <br /> z {6.33%/Ticket)FUEL RECOVERY FEE <br /> z SJ Cnty/AB 939 Fee at 2.00/TN 0.00 9.05 18.10 <br /> SJ Cnty/Rd Mitigation Fee at 0.16VTN /3SIS 0.00 g.05 1.45 <br /> ---Material Summary- <br /> SW-TI MBERlTREATEDIOLD <br /> 9.05, <br /> SI�tD -3L j' <br /> m a ACCOUNT STATUS l �5 <br /> o Ceerrent _ 3160 Days i9-!9 Days OMer s•Days _Tdai Amount Due <br /> @�.p p� ---- --I . <br /> N $689.89 I 0.00 - 0_06 .00 —689.__._...�1 <br /> .89 <br /> _-- _ ---- ♦ ♦Please return this portion below with your payment.Do not attach check to slub. �. d, <br />