Work Order Request Form

Client Name:

Client Address:

City:

Zip:

Client Email:

Client Phone

Date of Work Order

Date(s) Work Performed:

Description of Work Needed and Performed

Additional Comments:

Acceptance of Work and Hourly Rates: Please Note that Prices do not include any Engineering fees, Permitting fees or testing charges. If these items are needed, they will be at an additional charge plus 15%. Acceptance of Work and Hourly Rates: By signing below, I agree to allow Munyan to perform the work described above at the rate of $115.00 per man per hour and materials at cost plus 15% and a $250.00 one time trip charge. All credit card transactions will be charged the total plus up to 4% processing surcharge.

I Agree to Acceptance of Work and Hourly Rates Terms Above:

Owner Name:

Owner Signature

Authorizing Agent Name and Title:

Date of acceptance:

CGC-1529341 CGC-1524627 CGC-1533055 CGC-1523253 CCC-1330937 CCC-029612 CCC-1329932

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