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~c r S~_ <br />MARION COUNTY TELEPHONE ADD, MOVE AND CHANGE ORDER <br />DEPARTMENT Pv„b~ic ~O~ks CONTACT PERSON ~'; l I <br />LOCATION ~lsc1 ~Pr~I~ST~ MCR CONTACT PHONE I3R Sb36 <br />Building, Floor, Room, etc <br />BUDGET <br />PROJECT TYPE OF PHONE <br />SLl,Tap,Button <br />Description of add, move or change request: <br />T~S-ilAl~ 5~-~Ie lia~ ~-1n~,e ;,., ARC1~~ve~ v~~a_ b~Ck o.~ -- <br />_ <br />bt.c;ld~.v~ DN o~~S~ <br />-~ SfeS6 <br />- <br />P.UTHORIZED SIGNATURE DATE <br />WORK PERFORMED: 2NSTAt/e~ Gu~lil pl1~~,r• Soo Po.-c.f .'~ ---- <br />aitc~_~~.~~" '~s` .~ n~ 5~6 a ...~ . ` ~ ~ --- -- <br />.7M <br />JM <br />TECHNICIAN'S TIME ~~.5 <br />Date Sta.r_t Stop HRS MATERIALS Qty C::~st <br />S'~0•4'~ 8~ 3 O ~} : 30 ~~ d lJA!/ Phon.~e ~ .3 S'. 50 -- <br />i-~o-9~ l~~oo ~~~3 1!~'~S ~~r Svo ~ /OO.oa <br /> ~cvc s p2 w,I~z S'. S'o <br /> C~ y o~c 1 . 6S <br /> <br />SUBTOTAL 30~00 SUBTOTAL /''//• bS <br />~ / ~~, L/`~- <br />Work completed es No <br />~ Extension NRs issued: <br />T hnician's Signature <br />Depar ment verification of work performed <br />DN: .~l95 (o <br />Department Signature Date <br />FORM MC 11-PP26 REV 10/88 <br />White - Invoice Yeilow - Vendor Pink - Department <br />