HomeMy WebLinkAboutWORK ACCEPTANCE FORM ROCKY MOUNTAIN ELECTRIC - 21-00208 - Goldenwest Credit Union - Branch OfficeContractor 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
Rocky Mountain Electric, Inc.
LEE BOREN
City
IDAHO FALLS
State / Province / Region
ID
Postal / Zip Code
83401
Country
United States
Update new contact information that is not already on file with the City of Rexburg
Street Address
6698 N. 25TH E.
Address Line 2
rmeidanet@gmail.com 2085896826
Electrical 18230 3/31/2022 186,453.00$
Permit Information
Please enter in the following format: 00-00000
21-00208 GOLDENWEST CREDIT UNION
855 UNIVERSITY BLVD
Acceptance
Sign 8/5/2021