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BILLING INFORMATION FORM (Client to Complete) <br /> PROJECT NAME: Utility Undergrounding Consulting—Sunny Isles Beach <br /> PROJECT ADDRESS: <br /> Street Address <br /> City/State2ip <br /> LAND OWNER: <br /> OWNER ADDRESS: <br /> Street Address <br /> Gty/State/Lp <br /> OWNER PHONE NO: ( ) • <br /> OWNER CELL PHONE NO: ( <br /> E-MAIL ADDRESS: <br /> JOB SITE SUPERINTENDENT: <br /> JOB SITE PHONE: ( <br /> SUBDIVISION NAME: <br /> PURCHASE ORDER€: <br /> M_AIL INVOICE TO: <br /> Company Name <br /> ATTENTION: <br /> NameiTNe <br /> ADDRESS <br /> PHONE: <br /> FAX: <br /> SPECIAL BILLING INSTRUCTIONS: <br /> ``_ <br /> rKEITH and SCHNARS,P.A. <br /> r•US. ENGINEERS,PLANNERS, SURVEYORS <br /> m i <br />