HomeMy WebLinkAboutWORK ACCEPTANCE FORM EXCEL GENERAL CONTRACTORS LLC - 22-00059 - Java EspressContractor 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
Excel General Contractors LLC
Ken Allen
City
Francis
State / Province / Region
Utah
Postal / Zip Code
84036
Country
usa
Update new contact information that is not already on file with the City of Rexburg
Street Address
95 east 1495 south
Address Line 2
excelgc1111@gmail.com 435 640 7696
435 640 7696
Building RCE-63751 9/27/2023 800,000.00$
Permit Information
Please enter in the following format: 00-00000
22-00059 Java Espress
565 N 2nd E
Acceptance
Sign 11/1/2022