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DocuSign Envelope ID: 3EFOFF2D- AE78- 42B5- B6CA- 82C9778lC16E <br />* Applies only if toxic or hazardous substances or constituents are anticipated or encountered. <br />Proposal Number P18 -5 -6246 <br />FOR PAYMENT OF CHARGES <br />Charge Invoice to the Account of <br />Firm: <br />Attention: <br />Street Address: <br />City, State: Zip Code: <br />WORK AUTHORIZED BY <br />(Print Name & Title) <br />(Signature) <br />FOR APPROVAL OF CHARGES: (if different from above) <br />Send Invoice to: <br />Firm: <br />Attention: <br />Street Address: <br />City, State, Zip Code: <br />END OF DOCUMENT <br />Page 4 of 4 <br />(Date) <br />(Date) <br />