HomeMy WebLinkAboutWORK ACCEPTANCE FORM OMNI SECUTIRY SYSTEMS INC - 22-00502 - Mountain West Rental and Sales - 127 Airport RdContractor 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
Omni Security Systems Inc.
Mark Pettichord
City
Rigby
State / Province / Region
Idaho
Postal / Zip Code
83442
Country
Update new contact information that is not already on file with the City of Rexburg
Street Address
po box 309
Address Line 2
mark.omniss@gmail.com 2087451020
2083902296
Fire Alarm RCE-1278 1/4/2023 11,400.00$
Permit Information
Please enter in the following format: 00-00000
22-00502 mountain west rentals
127 airport road
Acceptance
Sign 11/2/2022