eoff pif form

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Eoff Electric Company Eoff Preliminary Lien / Bond Information Form Date: __________________________________ FIRST SHIPMENT DATE: ______________________________________LAST SHIPMENT DATE:________________________________________ Name of Project: __________________________________________________________________________________________________________________ Legal Address of Project:______________________________________________________________________________________________________________ City ____________________________________________________ State ____________________________________________ County ______________________________________ Description of Project: Residential Commercial Public Federal Other ______________________________ Materials/Services Supplied: ____________________________________________________________________________________________________ Purchase Order #: ________________________________________________________________________________________________________________ Total Amount of Sale $: ________________________________________________ Contract #: ________________________________________________ Reported Owner ____________________________________________________________________________________________________________________ Address ______________________________________________________________________________________________________________________________________ City, State, Zip ______________________________________________________________________________________________________________________________ Contact Information______________________________________________________________________________________________________________ (Phone) (Contact) General Contractor ________________________________________________________________________________________________________________ Address ______________________________________________________________________________________________________________________________________ City, State, Zip ______________________________________________________________________________________________________________________________ Contact Information______________________________________________________________________________________________________________ (Phone) (Contact) Lender/Bonding Agent ____________________________________________________________________________________________________________ Address ______________________________________________________________________________________________________________________________________ City, State, Zip ______________________________________________________________________________________________________________________________ Contact Information______________________________________________________________________________________________________________ (Phone) (Loan # / Bond) (Contact) Eoff’s Customer ______________________________________________________________________________________________________________ Address ______________________________________________________________________________________________________________________________________ City, State, Zip ______________________________________________________________________________________________________________________________ Contact Information______________________________________________________________________________________________________________ (Phone) (Contact) Eoff Employee Accepting Job________________________________________________________________Date ______________________________ Portland Salem Eugene Vancouver Bend Longview Medford Hillsboro Clackamas Prineville SE Portland Roseburg Albany Electrical Total Gear Total $ $ _________ Verify CCB 300K + Mgr In Resale Cert Enter Job Notify Branch Job Notice Enter SSheet Send Cus Ltr Bond Letter Scan Credit Use Acct #: Account Number:

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Eoff PIF Form

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  • Eoff Electric Company

    Eoff Preliminary Lien / Bond Information FormDate: __________________________________

    FIRST SHIPMENT DATE: ______________________________________LAST SHIPMENT DATE:________________________________________

    Name of Project: __________________________________________________________________________________________________________________

    Legal Address of Project:______________________________________________________________________________________________________________

    City ____________________________________________________ State ____________________________________________ County ______________________________________

    Description of Project: Residential Commercial Public Federal Other ______________________________

    Materials/Services Supplied: ____________________________________________________________________________________________________

    Purchase Order #: ________________________________________________________________________________________________________________

    Total Amount of Sale $:________________________________________________ Contract #: ________________________________________________

    Reported Owner____________________________________________________________________________________________________________________

    Address______________________________________________________________________________________________________________________________________

    City, State, Zip ______________________________________________________________________________________________________________________________

    Contact Information______________________________________________________________________________________________________________(Phone) (Contact)

    General Contractor ________________________________________________________________________________________________________________

    Address______________________________________________________________________________________________________________________________________

    City, State, Zip ______________________________________________________________________________________________________________________________

    Contact Information______________________________________________________________________________________________________________(Phone) (Contact)

    Lender/Bonding Agent ____________________________________________________________________________________________________________

    Address______________________________________________________________________________________________________________________________________

    City, State, Zip ______________________________________________________________________________________________________________________________

    Contact Information______________________________________________________________________________________________________________(Phone) (Loan # / Bond) (Contact)

    Eoffs Customer ______________________________________________________________________________________________________________

    Address______________________________________________________________________________________________________________________________________

    City, State, Zip ______________________________________________________________________________________________________________________________

    Contact Information______________________________________________________________________________________________________________(Phone) (Contact)

    Eoff Employee Accepting Job________________________________________________________________Date ______________________________

    1831

    Portland

    Salem

    Eugene

    Vancouver

    Bend

    Longview

    Medford

    Hillsboro

    Clackamas

    Prineville

    SE Portland

    Roseburg

    Albany

    Electrical Total Gear Total

    $ $

    _________

    Verify CCB

    300K + Mgr In

    Resale Cert

    Enter Job

    Notify Branch

    Job Notice

    Enter SSheet

    Send Cus Ltr

    Bond Letter

    Scan

    Credit Use

    Acct #:

    AccountNumber:

    lvaleTypewriter

    lvaleLine

    lvaleHighlight

    Last Shipment Date: Name of Project: Legal Address of Project: City: State: County: Other Description: Materials/Services Supplied: Purchase Oreder Number: Total Amount of Sale: Contract Number: Reported Owner: 1st Shipment Date: Reported Owner Address: Reported Owner City, State and Zipcode: Reported Owner Contact Telephone: Reported Owner Contact Name: Lender/Bonding Agent: General Contractor Address: General Contractor City, State and Zipcode: General Contractor Contact Telephone: General Contractor Contact Name: General Contractor: Eoff's Customer: Lender/Bonding Agent Address: Eoff's Customer Address: Eoff's Customer City, State and Zipcode: Lender/Bonding Agent City, State and Zipcode: Lender/Bonding Agent Contact Telephone: Eoff's Customer Contact Telephone: Eoff's Customer Contact Name: Eoff Employee Accepting Job: Lender/Bonding Agent Contact Name: Date Job Accepted: Commercial Project: Public Project: Federal Project: Other Project: Residential Project: Portland: Salem: Eugene: Vancouver: Bend: Longview: Medford: Hillsboro: Clackamas: Prineville: Roseburg: SE Portland: Albany: Verify CCB: