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F O R M 3 0 0 8 4 - 5 0 - 5 0 0 B ks. “ * W r le ^ n M Trfc&$?PAOT ---jp g Attf/alflii, A n n a --------19-64 ? E O l W f f __M o S B C a a p a ^ y _____________C o n tracto r. T h is is y o u r a u th o rity to p erfo rm th e follow ing w ork: D escrip tio n of W ork T o ta l C o st E X T R A O R D E R H O . 1 . W e ll Kn. i p i t n n 1 . 8 0 * A erst f i n n d l v s S 4 n a f ( t i o A d ifc io n fco 24 f t . p r o v id e d f n f f u _____________c o n t r a c t ) . 3 8 l i f t , f t , a t $ 1 1 , 0 1 -4kA'1 £9 •Rift 2 7 S k a Cem ent at | 1 ,8 6 » A A 1 8 b r a . w a i t i n g fn** A#m*nt --------SMI i t o act a t $ 1 2 .o o c Of f r u t Ite m 2 . T e s t pum ping ( i n a d d i t i o n t o 2 4 h ra W W V til I n \ 0 % h n c e l f i t A rs./\ Ite m 3 . 1 0 * W e ld in g f l a n g e , 1 • & . * t $ 8 6 ,0 0 O K * wit* f>f * Item 4 . C i r c u m f e r e n t i a l w e ld in g ( « » a d d i t i o n t o 200 f t . p r o v id e d f o r f n c o n t m c t ) 220 f t . a t $ .3 0 . 8 8 - = 0 0 T h is w ork to be perform ed u n d e r a n d in accordance w ith c o n tra c t d a te d . 10 7 6 9 _______ L a s ¥ A u d it N o— egaa Land and l y t ^ p .C om p an y C o n tra c to r’s bills will n o t be accepted unless th e expense h as been a u th o rized b y o rd er on th is form , a n d all bills w ith o u t exception m u st show th e n u m b er of th e o rd er au th o rizin g th e expense. Bills m u st be rendered p ro m p tly a fte r th e close of th e m o n th in w hich th e w ork w as p e rform ed o r m aterial furnished. If th e y are n o t p resen ted w ith in 30 d a y s a fte r th e close of th e m o n th d u rin g w hich th e w ork w as perform ed o r th e m aterial w as furnished, th e y will n o t be accepted. lo---- x ORlOfK^L SKKEB (S e a l) R. L ADAMSON Accepted: R o sco e M oss Company / a / A . A . B a rn ey^ E n g i n e © * * (T itle ) e y v - CONTRACTOR