Laserfiche WebLink
FORWARD, INC. �� <br /> INVOICE <br /> 1145 West Charter Way <br /> Stocldon, CA 9.5206 Invoice Date 01/15/2019 <br /> Invoice No 4204-000052186 <br /> REPUBLIC Custoffw No 4-420410317 <br /> Sys <br /> 1-2RSTL,IDTSH 000354 Page No 1 of 2 <br /> Ili'Illyile+Ill'11I111iliee+II6In1Iy1+I+id+illiln+e1111+1a1 Due Date 02114/2019 <br /> H&H ENGINEERING CONSTRUCTION Currey <br /> MARIA JAIMES Charges Total Amount Due <br /> 212 INDUSTRIAL DRIVE $5.12 <br /> STOCKTON, CA 95206 <br /> Please Pay Total Amount Due <br /> t3iiling Questions?Call 209-466-4492 <br /> 1MPORTANTnH To ensure your payment is posted to the correct invoice,we need <br /> the torn remittance from your invoice.Thank you. <br /> Date Code Description Releleace Rade Quan Antouint <br /> r 01/15 VS SW-TIMBERIfREATED/OI.D YS 1357832 61.45 5.29TN 614.50 <br /> m 01115 VS Reference:5514684 <br /> 01115 VS Vehicle: DCC 3355 ,DCC 40YD <br /> D <br /> 01/15 VS Contract 4204122008 <br /> 01/15 VS Generator Name: H&H ENGINEERING <br /> z 01J15 1 ENVIRONMENTAL FEE 1 <br /> z { SC829159 16.25 1.00 16.25 <br /> z -16.25/Ticket ENVIRONMENTAL FEE 1 1 <br /> z 01/15 11 FUEL RECOVERY FEE SC829160 42.46 1.00 42.46 <br /> z (6.91%/Ticket)FUEL RECOVERY FEE <br /> z SJ Cnty/AB 939 Fee at 2.00/TN ��� � � 0.00 5.29 10.58 <br /> z SJ Cnty/Rd Mitigation Fee at 0.161TN 0.00 5.29 0.85 <br /> SJ Cnty/Env Health Fee at 0.09/TN JAN 2 5 2nis 0.00 5.29 0.48 <br /> --Material Summary----- <br /> SW-TIMBERJTREATED/OLD �� ENG. CONST 5 29 <br /> 0 <br /> ACCOMT STATUS <br /> _ Days Over 90 Days v Total AniowMDue— <br /> Current 3150 Qeys 61-80 —} <br /> N $1,475.15 0.00 0.00 0.00 $1,476,15 <br /> O+ <br /> v <br /> 4 4 Please Eelwn.this portion below with your payment.Do not attach check to stub. 4 .� <br />