HomeMy WebLinkAboutWORK ACCEPTANCE FORM ROCKY MOUNTAIN ELECTRIC, INC. - 22-00655 - Madison Memorial Hospital - Storage ExpansionContractor 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 acknowledge that I am the indicated contractor for the above mentioned Permit/Project.
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 North 25th East
Address Line 2
RMEIDANET@GMAIL.COM 2085896826
Electrical 18230 3/31/2023 46,800.00$
Permit Information
Please enter in the following format: 00-00000
22-00655 MMH HEADWALL REPLACEMENT
450 E. MAIN ST., REXBURG
Acceptance
Sign 8/31/2022