I certify that the statements and information on this application are true and correct to the best of my knowledge. I release HU to conduct a background of the information included on, but not limited to, this form and also authorize HU to request, receive, and verify from any source all information given in this application, except as specified, and hereby release all parties from any liability that may result from furnishing such information to HU. _________________________________________________________________ ______________ Signature of person completing application Date Attachment H (Pricing Sheet) Item Model Number Number Unit of Quoted Description Quoted Quantity Measure Price High Automated Valve 79-000-07 Operator, Exercisor and 1 Each $ Rehabilitator Controller/Datalogger 79-422-01 1 Each $ Telescopic Valve Key 11-408-00 1 Each $ Desktop Dock 79-110-09 1 Each $ Extended Protection Plan (3 YR) 79-110-13 1 Each $ $
I certify that the statements and information on this application are true and correct to the best of my knowledge. I release HU to conduct a background of the information included on, but not limited to, this form and also authorize HU to request, receive, and verify from any source all information given in this application, except as specified, and hereby release all parties from any liability that may result from furnishing such information to HU. _________________________________________________________________ ______________ Signature of person completing application Date Attachment H (Pricing Sheet) Description Item Number Quoted Model Number Quoted Quantity Unit of Measure Price High Automated Valve Operator, Exercisor and Rehabilitator 79-000-07 1 Each $ Controller/Datalogger 79-422-01 1 Each $ Telescopic Valve Key 11-408-00 1 Each $ Desktop Dock 79-110-09 1 Each $ Extended Protection Plan (3 YR) 79-110-13 1 Each $ $
IFB-18-48-Hydraulic-Valve-Exerciser.docx