Get Sunrise Powerlink Grant

Lineal Feet Description and Brand Quantity if applicable TOTAL COST OF APPROVED RETROFIT ITEMS PARCEL NUMBER Owner Signature This is a true and accurate statement of expenses incurred. Sunrise Powerlink Fire Mitigation Grants Program PO Box 249 Alpine CA 91903 Page 2. Approved Work Completed by July 15 2013 2013 Sunrise Powerlink Grant Work Completed Form Structure Hardening Owner Last Name Work Location Address State Approved Receipts submitted by July 31 2013 First Name Parcel Number City Phone No Zip Owner s Email Address Type of Work Windows Roof Eaves Deck Vents Fence Other Structure s where work was conducted Work Labor Detail Provide description of labor activities Dates hours rates and total amount. Attach copy of dated Service Invoice s not work quote from the approved work conducted by outside contractor s in year 2013 including Fire Code house number installation if conducted* Labor detail is not applicable if retrofit item costs on following page exceed the Grant maximum of up to 2 048. 47 Labor Date Activity Hours Rate Amount TOTAL LABOR Page 1 Approved Retrofit Items Attach copy of dated Invoice s /receipts not work quote for purchased 2013 Grant Program retrofit items including Fire Code house numbers. Approved Work Completed by July 15 2013 2013 Sunrise Powerlink Grant Work Completed Form Structure Hardening Owner Last Name Work Location Address State Approved Receipts submitted by July 31 2013 First Name Parcel Number City Phone No Zip Owner s Email Address Type of Work Windows Roof Eaves Deck Vents Fence Other Structure s where work was conducted Work Labor Detail Provide description of labor activities Dates hours rates and total amount. Attach copy of dated Service Invoice s not work quote from the approved work conducted by outside contractor s in year 2013 including Fire Code house number installation if conducted* Labor detail is not applicable if retrofit item costs on following page exceed the Grant maximum of up to 2 048. Attach copy of dated Service Invoice s not work quote from the approved work conducted by outside contractor s in year 2013 including Fire Code house number installation if conducted* Labor detail is not applicable if retrofit item costs on following page exceed the Grant maximum of up to 2 048. 47 Labor Date Activity Hours Rate Amount TOTAL LABOR Page 1 Approved Retrofit Items Attach copy of dated Invoice s /receipts not work quote for purchased 2013 Grant Program retrofit items including Fire Code house numbers. Approved Work Completed by July 15 2013 2013 Sunrise Powerlink Grant Work Completed Form Structure Hardening Owner Last Name Work Location Address State Approved Receipts submitted by July 31 2013 First Name Parcel Number City Phone No Zip Owner s Email Address Type of Work Windows Roof Eaves Deck Vents Fence Other Structure s where work was conducted Work Labor Detail Provide description of labor activities Dates hours rates and total amount. Attach copy of dated Service Invoice s not work quote from the approved work conducted by outside contractor s in year 2013 including Fire Code house number installation if conducted* Labor detail is not applicable if retrofit item costs on following page exceed the Grant maximum of up to 2 048. 47 Labor Date Activity Hours Rate Amount TOTAL LABOR Page 1 Approved Retrofit Items Attach copy of dated Invoice s /receipts not work quote for purchased 2013 Grant Program retrofit items including Fire Code house numbers.