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f6, s <br /> k' <br /> INVOICE <br /> FORWARD,4YW'l61R©, INC. <br /> 1145 West Charter Way Invoice(Date 0913012019 <br /> Stockton,CA 9.5206 Invoice Me 4204-"053728 <br /> REPUBLIC Customer f0 4-4204-0010317 <br /> SER`b`CC E'S <br /> L2RSTT0TGK M11B77 Page No 1 of 2 <br /> n111 11� Ilo 11, I alsllll 9�lil g91a.�ur JI oar 9on110 Due Date 1013072019 <br /> H & H ENGINEERING CONSIMUCTION + IV�� Cunw t Charges Tota9 Amount.Daae <br /> 0.1 <br /> i MARIA JAIMES ECL <br /> 212 INDUSTRIAL DRIVE - $336." �2a266.93 <br /> S T OCbtTOPd. CA 95206 <br /> SEP 0 9 2020 Please Pay Total Amount Dane <br /> ENV IRO\\lF.\T:�l, III: "di4iQuestions? Call 209-466-4492 <br /> F <br /> PORTANTM To ensure your payment is posted to the correct unvoice,we neede toren remittance from your invoice.Thank you. <br /> Date Code Descnbon Rekfenw Rade QuaMy Amount <br /> 09124 VS SW-TlWEPJTREATEDIOLD Y8 1413882 64.50 11.56 TN 74562 <br /> 09124 VS Refererice:5770883 <br /> 0924 VS Vehide:DCC 3359 ,DCC 40YD <br /> ® 09124 VS Contract 4204122008 f x0 <br /> 09124 VS Generator Mame:H&H ENGINEERING <br /> z 09124 (1 ENVIRONMENTAL FEE 1 19y <br /> SC911027 16.25 1.00 1fi25 <br /> z -16.251 Ticket ENVIRONMENTAL FEE <br /> z 09124 )1 FUEL RECOVERY FEE SC911028 4876 1.00 48.75 <br /> z <br /> z <br /> z (6.54%1 Ticket)FUEL RECOVERY FEE <br /> z SJ Cnty/AB 939 Fee at 2.00/TN 0.00 11.56 23.12 <br /> z <br /> z 0.00 11.56 1.85 <br /> SJ Cnty 1 Rd Mitigation Fee at 0.16(TN <br /> SJ Cnty/Env Health Fee at 0.09ITN 0.00 11.56 1.04 <br /> Material Summary------ OCT OR <br /> SW-TIMBERITREATED/OLD <br /> 0 <br /> 0 <br /> N <br /> ACCOUNT sTATt)S -- ,- ----- - -—---—--- ----- ---- <br /> p cuRa,e st-a t_ °� -- - ToaAr wM ye OCT 0 7 2019 <br /> tsis0"s <br /> - <br /> $2,28&93 _ 0.00 T— 0-00-- _ 1--- -°—°0------ $2.2ss.9a <br /> a <br /> H&H ENG. CONS7 <br /> 0 <br /> J, 4-Please return this portion below with your payment.Do not attach check to stub. 4 S. <br /> ------- <br />