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CDSR0030-12.0 Estimate of Cost and Authorityto Work Page 2 of 2 <br /> KM2842 a`&{`` Special Construction Charge and Invoice <br /> 06/25/2021 <br /> AT&T ILLINOIS <br /> ACTUAL COST BASIS <br /> Customer Request Number 207975 Date : 06/25/2021 <br /> Project Number A01Y6DR Customer ID : 156323 <br /> DESCRIPTION OF CUSTOM WORK: <br /> RELOCATE TERMINAL BOX <br /> LM VM FOR STEVE <br /> ESTIMATED COST FOR CUSTOM WORK: $153,563.66 <br /> Applicant understands that pursuant to the tariffs on file with the FCC and with the State of Illinois and/or in order to induce AT&T to relinquish or <br /> modify its property right, it is my responsibility to pay these costs incurred by Illinois Bell Telephone Company,d/b/a SBC Illinois, an Illinois corporation <br /> to complete the work requested. <br /> Applicant has asked AT&T to perform the above-described custom work for which Applicant shall pay AT&T the contract price of One Hundred Fifty- <br /> Three Thousand Five Hundred Sixty-Three Dollars And Sixty-Six Cents/$153,563.66 in advance of the start of any AT&T work. <br /> Applicant shall pay for the work on an "Actual Cost" basis. Upon completion of the work, AT&T will compute the actual cost of the work. Any <br /> difference between the amount of advance payment and the actual cost will be either paid by the Applicant to AT&T or refunded to Applicant by AT&T <br /> as the case may be.Applicant understands that this amount is only an estimate of approximate costs,and that the actual cost incurred by AT&T and <br /> for which the Applicant is responsible may be different. <br /> Charges are calculated in accordance with AT&T's ordinary accounting practices under the Uniform System of Accounts for Class A telephone <br /> companies and include allocated costs for labor, engineering, materials, transportation, motor vehicles, tool and supply expenses and corporate <br /> overhead loadings. <br /> The estimated amount of One Hundred Fifty-Three Thousand Five Hundred Sixty-Three Dollars And Sixty-Six Cents/$153,563.66 is valid <br /> for only thirty(30)days and is therefore subject to change/cancellation after July 25,2021 if AT&T has not received an executed copy of the <br /> Application and advance payment by that date. <br /> If Applicant cancels the work prior to completion, Applicant shall pay AT&T for all costs AT&T has incurred before being notified in writing to cease <br /> work. <br /> ACCEPTED FOR APPLICANT: SEND PAYMENT PAYABLE TO: <br /> BY: 41 AT&T Midwest-CWO Center <br /> 220 Wisconsin Avenue-Floor 2, <br /> 7)_1 <br /> Printed Name: Waukesha,WI 53186 <br /> Title: <br /> Date Signed: A aj <br />