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<br />MARION COUNTY TELEPHONE ADD, MOVE AND CHANGE ORDER
<br />DEPARTMENT (~; ~~' ~i ;~ f-' 1~~~. `~> CONTACT
<br />_ PERSON ~~ t..r i~.i
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<br />LOCATION _ CONTACT PHONE NR ~`il~
<br />Building, Flocr, Room, etc
<br />BUDGET _ _ PROJECT _ ~ ~'YpE OF PHONE _ I,~%1 y- -' >t J
<br />SL1,Tap,Button
<br />Description of add, move or change request:
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<br />HU1riVK1Y,~U 51CiNA'1'ux~ DATE
<br />WORK PERFORMED: ~1t~:tr'f~ i,%'~'t k t ~s~: > 1U+,~' J.~~,,,~~{'t_t~ j~ -o _,_-_= _
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<br />TECHNICIAN'S TIME ~'~'
<br />Date Start Stop HRS MATERIALS Qty Cost
<br />,4`....- . ~'LS {.11. ~ L;. ~ ~, ~~
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<br />SUBTOTAL ~~ ~:~~-'~ ~-~~ L.i SUBTOTAL
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<br />DATE BILLED ~-~~ /"~i~~~
<br />TOTAL CHARGED ~-}~_•`
<br />l r ; Work completed %'~~e,~ No
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<br />~~~:- . ~~~.: ~ Extension NRs issued:
<br />T~ hnician's Signature ~p~~~,
<br />Depa~` ent verification of work performed
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<br />Department Signature Date
<br />FORM MC 11-PP26 REV 10/88
<br />White - Invoice Yelic~w - Vendor
<br />Pink - Department
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