HomeMy WebLinkAboutWORK ACCEPTANCE FORM D CO CONCRETE LLC - 21-00305 - BYUI Ricks Building - Chiller & Ice Bank UpgradeContractor 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
D Co Concrete LLC
DONNY N FLORES
City
Pocatello
State / Province / Region
ID
Postal / Zip Code
83204
Country
United States
Update new contact information that is not already on file with the City of Rexburg
Street Address
2216 Tascile Ln
Address Line 2
donny.vino@hotmail.com 2086044963
Building RCE-42140 5/26/2021 10,865.50$
Permit Information
Please enter in the following format: 00-00000
21-00305 RKS Chiller & Ice Bank
Rexburg, ID
Acceptance
Sign 5/11/2021