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HomeMy WebLinkAboutWORK ACCEPTANCE FORM WIND RIVER CONSTRUCTION - 20-00248 - Vista Medical Office - Lot 3, Blk 1 Trejo Professional ParkContractor Work Acceptance Form Business Name:* Contact Name:* Mailing Address Email:*Phone:* Mobile: Discipline:*License #:*Expiration Date:*Value of Work: Permit Number:* Project Name:* Project Address:* By signing, I acknowle dge that I am the indicate d contractor for the abov e me ntione d Pe rmit/Proje ct. Signature Date Contractor/Subcontractor Wind River Construction Quinn Webb City Idaho Falls State / Province / Region Idaho Postal / Zip Code 83402 Country Update new contact information that is not already on file with the City of Rexburg Street Address 2420 S Yellowstone Hwy Address Line 2 Ste E quinn@windriverconstruction.com 2082218664 2082218664 Building 41186 2/2/2021 650,000.00$ Permit Information Please enter in the following format: 00-00000 20-00251 Vista Medical 576 Trejo St Acceptance Sign 6/8/2020