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FORWARD, INC. INVOICE <br /> 1145 West Chatter Way <br /> invoiceStockton, CA 952+06 voice Date 03/3i/2018 <br /> Invoice No 4204-000050391 <br /> REPUBLIC Customer No 4-4204-0010317 <br /> sFFtyICES <br /> L2RSTLDrs© 2DO1 12 Page No 1 of 2 <br /> 1�l1e�l�eellll°1111'Ige�e�ellllllll'l111'�I'1�'I'�'lI1�IH1111'll Due Date 04/30/2018 <br /> ` H&H ENGINEERING CONSTRUCTION Current Charges Total Amount Due <br /> MARIA JAIMES _ <br /> 212 INDUSTRIAL DRIVE $GE8.35 ! j =1,497.2__67A <br /> STOCKTON,CA 95205 <br /> Please Pay Total Amount Due <br /> Billing Questions?Call 209-456-4492 <br /> WPORTANT111 To ensure your payment is hosted to the correct invoice,we need <br /> the torte remittance from your invoice. Thank you. <br /> Date Code Descnpbon ------- .-- -- -- RPIP Pnoe Rage Quanf�l Amount <br /> ON28 VS SW-TIMBERKREATEDIOLD Y81297107 61.45 7.44 TN --- 614.50 <br /> 03/28 VS Reterence:4457748 <br /> ° 03/28 VS Vehicle:DCC 3364,DCC 40YD <br /> 0 <br /> 03/28 VS Contract: 4204122008 <br /> N 03/28 VS Generator Name: H&H ENGINEERING <br /> z <br /> z03/28 (1 ENVIRONMENTAL FEE 3 SC744636 16.25 1.00 16.25 <br /> z <br /> z ( 16.25/Ticket)ENVIRONMENTAL FEE 1 <br /> z 03/28 11 FUEL RECOVERY FEE SC744637 40.86 1.00 40.86 <br /> z (6.65%/Ticket)FUEL RECOVERY FEE <br /> z SJ Cnty/AB 939 Fee at 2.00/TN '' r" ;�4tr 0.00 7.44 14.88 <br /> z SJ Cnty/Rd Mitigation Fee at 0.161TN 0.00 7.44 1.19 <br /> SJ Cnty/Env Health Fee at 0.09/TN0.00 7.44 0.67 <br /> --Material Summa !!�' I' 21E i1 <br /> SW-TIMBER/TREATED/OLD 7.44 <br /> 0 3s►r � <br /> ACCOUNT STATUS �,O �— <br /> N Current 3148—Dap-- - $140 Drys Over So Wys _T Tc"Awuat Due � 3= <br /> $1,497.26 0.00 0.00 0.00 $1,497.26 50�1C7 <br /> N a I-5 <br /> b -�Please return this portion below with your payment.Do not attach check to stub. J. 4- <br />