Laserfiche WebLink
11111111111J <br />0 ydn nt II'\11etu Il...r..:as:p::: �::;ur:::imeuut (.3" <br />14199jasper St NW • Ramsey, MN 55303 <br />Public Works Facility 763.433.9839 <br />www„cutyaramsey.connu <br />(.:1:c ou ru: lr Ilun c.Al0 ,. - <br />Company Name: <br />Address: <br />Email: <br />Phone: <br />Name: <br />Project Title: <br />Mobile Phone: <br />I' 1IelI:er IIu u11r:Nrtiir..yll: <br />Meter ID #: Meter Size: <br />Beginning Reading: Ending Reading: <br />Gallons Used: Hydrant Wrench ❑ <br />.i.� a u, rn .sa In :::nun s <br />By signing below, I, the undersigned contractor, agree to abide by the terms of the Hydrant Meter Lease Agreement <br />and acknowledge receipt of a copy of this agreement. <br />A deposit of $4,350 is required at the time of rental. The deposit will be cashed and held by the City of Ramsey until <br />the meter is returned. If the meter is damaged, the cost of repairs or replacement will be deducted from the deposit. <br />If the meter is lost or stolen, the deposit will not be refunded. <br />I further agree to hold harmless the City of Ramsey from any injury or damage to myself, my staff, my personal <br />property, customers' property, and/or equipment that may occur as a result of the use of the rented equipment <br />listed above. <br />A t h 4: r II ;”'a't, II f:;o lr0 <br />Signature: <br />Printed Name: <br />Date: <br />IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII <br />It is our mission to work to ether to.responsibly gro our community,, and to provide q ..trip cost e.fkctive and e$ide t; overn <br />services° <br />