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FORWARD, INC. <br /> INV <br /> OICE E <br /> 1145 West Cfilart�e�r Way <br /> Stoddon, CA 95206 Invoice Date 03/1.-5/2019 <br /> Invoice No 4204-00005247.3 <br /> REPUBLIC Customer No 4-4204-0010317 <br /> SERVICES <br /> LZRSTTBT°r &Xja° Page No 1 of 2 <br /> Ie1.IIIr�l.yrl.nrlldlrala��h'Irl�ll�l"IIIr��Iu11�a�e11r1�J Due Date 04714,/2019 <br /> H&H ENGINEERING CONSTRUCTION <br /> MARIA,JA11lraES Current Charges Total Amount Due <br /> -- ------6---- <br /> 12 INDUSTRIAL DRIVE 474 .13 $1,663.15 <br /> STOCKTON, CA 952D6 <br /> Please Pay Total Amount Due <br /> Billing Questions?Cal] 209-466-4492 <br /> IMPORTANTM To ensure your payment is posted to the correct invoice,we need <br /> the tom remittance from your invoice.Thank you. <br /> Oak Code <br /> in - — - -- �Otl--- --------- Reference Rate Quan — A otast <br /> - - <br /> 0304 VS SMY-TIMBEWREATEDIOLD -- Y81367430 64.50 10.29TIN 653.71 <br /> 03/04 VS Reference:5514686 i'Jh\ 1 <br /> 03/04 VS Vehicle: DCC 3357 ,DCC 40YTD �� <br /> 03/04 VS Contract 4204122006 <br /> OND APR 14 2019 <br /> 03/04 VS Generator Name:H &H ENGINEERING !!,^� <br /> z 03/04 {1 ENVIRONMENTAL FEE 1 yJ �h SC844604 16.25 1.00 16.25 <br /> z -16.25/Ticket ENVIRONMENTAL FEE 1 1 2' <br /> z 03104 }1 FUEL RECOVERY FEE SC844605 43.01 1.D0 43.01 <br /> z (6.48%/Ticket)FUEL RECOVERY FEE <br /> Z SJ Cnty I AB 939 Fee at 2.D0/TN �t ����E� 0.00 10.29 20-58 <br /> z SJ Cnty/Rd Mitigation Fee at 0.16/TN 0.00 10.29 1.65 <br /> SJ Cnty/Env Health Fee at 0.09/TN 0.00 10.29 0.93 <br /> --Material Summary-- - APR 0 2 2019 <br /> 01 SW-TIMBERffREATEDJOLD ���� 10.29 <br /> Cl <br /> �. <br /> ACCOUNT STATUS <br /> r <br /> -- <br /> Cwrent { 3140 Days 61-99'Days Over 90 Days Total Arnount Due <br /> N $1,663.15 y 0.00 0,00 0.00 $1.663,15 <br /> o — --- ---- -- - <br /> V <br /> co <br /> y y Please return this portion below with your payment.Do not attach check to stub. y y <br />