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1. WAGES FOR HIRED MC' ~'=RS: Fill in dates, workers name~ ~ours worked, and rate requested. <br />,4ttacf ~ proof of worker's wag _~,~ate. <br />Oate Worker's Name Hours <br />Worked Hourly <br />Rate Total <br />03/15/97 Capitol City Trsf (Bekins) $ 1,141.08 <br />03/15/97 Arden's Cabinet Shop . 6,720.00 <br /> <br />7 C~i IIO~A CAIT f~CA1TA I. r,~~ ~_ ~_._ . <br />~~~~ ~~~c ~~_~, ~yN~ v~ equ~~men~, nours used, and rate. Attach receipts <br />or other documentation of expense. . <br />Oate Equipment Used Hours <br />Used Hourly <br />Rate Total <br /> <br /> <br /> <br /> <br />'] r1TLlf"1") t"vnrr.ic+rn. r-~_~_ <br />~~~~ ~~.i~~ ~.i~vt~v. L~pIG~ 4G~.JGII~~IUfI, ana cost must be ti~~ed in. Attach invoice or other <br />documentation of expense. <br />Date Description Cost Total <br />03/18/97 Cable & Telephone installation $ 3,115.00 <br />03/21/97 Cable & connect install 275.00 <br /> o uter set-u 680.00 <br /> <br /> <br />TOTAL $11,931.08 <br />Mar Po Federal Credit Union <br />~, ~~.~ ~ - ay -9 ~ <br />~ <br />Form 223 (7/95) RELOCATIO N <br />ACTUAL COST NON-RESIDENTIAL MOVE CLAIM <br />