128466864
December 24, 2024
Customer Payment
Coupon
References
Notification # 128466864
Contract # 50115291 V1
E15-PM # 35596775
E16-PM # 35596775
E-Prior MLX/PM # 264586
Customer # 4529160
City of Foster City
610 Foster City Boulevard
FOSTER CITY, CA 94404
Customer Payment Summary
650 SHELL BOULEVARD, FOSTER CITY
Please pay the Total Due based upon the payment option(s) you selected on page two of the enclosed Gas and Electric Extension Agreement.
Payment Options Subtotal Total Due
10-Year Refundable Advance Option Gas and Electric $180,949.28 $177,949.28 Non-Refundable 50 percent Discount Option for Gas and
Electric
$91,633.15 $88,633.15
10-Year Refundable Advance Option for Gas and
Non-Refundable 50 percent Discount Option for Electric
$91,633.15 $88,633.15
Non-Refundable 50 percent Discount Option for Gas and
10-Year Refundable Advance Option for Electric
$180,949.28 $177,949.28
The Total Due for each payment option above includes:
Advance Credit ($3,000.00)
Important Payment Information
To complete your contract ONLINE
Follow the instructions provided with your electronic contract Submit payment at https://www.pge.com/contractpayments
To complete your contract BY MAIL
Please make check payable to: PG&E or Pacific Gas and Electric Complete, sign and return the enclosed agreement(s), the SACAC form and the customer payment coupon with your payment
Remit payment and SACAC form to:
PG&E CFM/PPC Department
PO BOX 997340
Sacramento, CA 95899-7340
IMPORTANT MESSAGE
Please review the enclosed information
and total due. This document needs
to be returned with the enclosed
agreements.
If you complete your contract ONLINE,
a copy will be saved to your Customer
Connections Online (CCO) account at
pge.com/cco.
To learn more about PG&E's gas and
electric safety initiatives and resources
please visit pge.com/safety.
Have Questions?
Please Call 1-800-422-0436
Gas and Electric
Extension Agreement*
* Automated document,
Preliminary Statement, Part A
"PG&E" refers to Pacific Gas and Electric Company, a subsidiary of PG&E Corporation. ©2015 Pacific Gas and Electric Company. All rights reserved.
Form 79-1169
Advice 4862-G/7158-E
January 2024Page 1 of 2
128466864
For Internal Use
128466864Notification #
50115291Contract #
35596775E-PM #
G-PM #
264586E-Prior MLX/PM#
G-Prior MLX/PM#
4529160Customer #
1V
December 24, 2024
City of Foster City
610 Foster City Boulevard
FOSTER CITY, CA, 94404 650 SHELL BOULEVARD, FOSTER CITYRe:
Stefan ChatwinDear
We are writing to let you know Pacific Gas and Electric Company (PG&E) will extend its facilities to provide the requested gas and electric service to the project address listed above. PG&E's costs have been developed based on the choices and information provided in your application and may change if you make changes. This letter, including PG&E's tariffs, which are incorporated by reference below, will serve as our contract. As required by the California Public Utilities Commission (CPUC), special facilities will be handled in a separate contract. Per Decision 22-09-026, Residential and Non-residential Customers submitting an application for new gas service on or after July 1, 2023, do not qualify for Allowances, Refunds or Discount Option.
Per Decision 23-12-037, Mixed-Fuel New Constructions project applications received after July 1, 2024, will not qualify for Allowances, Refunds, or Discount Option. For new applications for Gas Service Extension(s) on or after July 1, 2023, and Mixed Fuel New Construction projects after July 1, 2024, Applicants must pay PG&E its total estimated installed cost upon contract execution, in advance of PG&E commencing its work. Upon completion of the work and determination of actual costs, PG&E will provide Applicant with a final invoice or refund to account for a true-up to actual costs. An Applicant's failure to pay a final invoice in a timely manner is a violation of PG&E's Gas Rules 15/16 and may result in discontinuance of service. Non-Residential Customers submitting an application for new gas service on or after July 1, 2023 may qualify for Allowances, Refunds or Discount Option if approved by the CPUC. Please complete the following four steps to execute this contract.
1 Review the following work responsibilities and cost information.
Work To Be
Done By
GAS MAIN GAS SERVICE ELECTRIC DISTRIBUTION ELECTRIC SERVICE Trench Pipe Trench Pipe Trench Substr. Facilities Trench Substr. Facilities
PG&E X X
Customer
GAS ELECTRIC
Total non-refundable project costs $0.00 $2,317.03
Refundable extension costs $0.00 $213,127.43
Allowances (credit) $0.00 - $34,495.18 -
Net refundable amount $0.00 = $178,632.24 =
10 YEAR REFUNDABLE OPTION
Net refundable amount $0.00 $178,632.24
Credit for value of design and/or
facilities provided by applicant
$0.00 - $0.00 -
Total non-refundable project costs $0.00 + $2,317.03 + Total (if you select this option) $0.00 = $180,949.27 = NON-REFUNDABLE 50% DISCOUNT OPTION
Net refundable amount $0.00 $178,632.24
Discount: 50% of Net refundable amount $0.00 - $89,316.12 - Credit for value of design and/or
facilities provided by applicant
$0.00 - $0.00 -
Total non-refundable project costs $0.00 + $2,317.03 + Total (if you select this option) $0.00 = $91,633.15 = Potential refund per residential lot/unit $0.00 $0.00 Potential reimbursement per service completion
Pressurized or energized system $0.00 $0.00
Not pressurized or energized system $0.00 $0.00
Reimbursement for other work
performed $0.00 $0.00
All amounts include the Income Tax Component of Contribution (ITCC) PG&E is required to charge customers, where applicable.
DEFINITIONS AND EXPLANATION OF TERMS
(For more detail see rules 15 and 16):
Total non-refundable project costs include costs for
work such as electric trench and excavation, conduits,
inspections, streetlights, conversion from overhead to
underground and contract processing.
Refundable extension costs include costs for facilities such as electric conductor, transformers and poles; gas pipe, gas share of distribution trench and regulators;
and meters.
Allowances are a credit against refundable extension
costs. They are based upon the number of residential
units expected to be connected within the first six
months and the expected annual non-residential net
(distribution) revenue from your project.
Allowances granted under either option are subject to
deficiency billing if the number of residential units
connected or the annual non-residential net revenue
falls below the forecast used to calculate the
allowances.
Net refundable amount is the portion of overall costs
eligible for refund to you based upon additional
residential meters being set or upon increases in non-
residential annual net (distribution) revenue. A cost-of- ownership charge is assessed against the Net
refundable amount (except for individual residential
applicants) per Rule 15.
Potential refund per residential lot/unit is for those
lots/units for which you did not already receive an
allowance (i.e., units not expected to be connected in
the first six months). Any refunds may be decreased or
eliminated by cost-of-ownership charges assessed
under the provisions of Rule 15.
Potential reimbursement per service completion is
the amount to which a customer may be entitled for
performing certain service connection work PG&E
would otherwise perform when installing service
extensions and are not to be confused with refunds.
Reimbursement for other work performed is
the amount to which a customer may be entitled
for performing certain work (other than service
completions) that normally is PG&E's responsibility.
Gas and Electric
Extension Agreement*
* Automated document,
Preliminary Statement, Part A
"PG&E" refers to Pacific Gas and Electric Company, a subsidiary of PG&E Corporation. ©2015 Pacific Gas and Electric Company. All rights reserved.
Form 79-1169
Advice 4862-G/7158-E
January 2024Page 2 of 2
128466864
2 Select one of the following payment options.
#opt1#
10-Year Refundable Option for Gas and Electric
#opt2#
Non-Refundable 50 Percent Discount Option for Gas
and Electric
#opt3#
10-Year Refundable Option for Gas and Non-
Refundable 50 Percent Discount Option for Electric
#opt4#
Non-Refundable 50 Percent Discount Option for
Gas and 10-Year Refundable Option for Electric
Gas
$0.00
$0.00
$0.00
$0.00
+
+
+
+
Electric
$180,949.28
$91,633.15
$91,633.15
$180,949.28
-
-
-
-
Advance
SEE PMT CPN
SEE PMT CPN
SEE PMT CPN
SEE PMT CPN
=
=
=
=
Total Due
$180,949.28
$91,633.15
$91,633.15
$180,949.28
3 Review these important terms and conditions.
This Gas and Electric Extension Agreement is controlled by, and incorporates by reference, PG&E's tariffs, including Gas and Electric rules 2, 15, and 16; the Distribution and Service Extension Agreement-Provisions (Form 62-0982) and the General Terms & Conditions for Gas and Electric Extension & Service Construction by Applicant (Form 79-716), all as approved and authorized by the CPUC. This agreement at all times shall be subject to such modifications as the CPUC may direct from time to time in the exercise of its jurisdiction.
You can view PG&E's tariffs online at pge.com/tariffs or contact the PG&E representative listed below. Additional details underlying the amounts shown in this agreement, as well as the calculation of allowances, refunds or deficiency bills can also be provided by your local PG&E representative. 4 After completing steps 1, 2 and 3 and having checked one, but only one, of the four payment options above, please complete and return the following items to PG&E.
Sign and return this contract as indicated below.
Submit the Payment Coupon with Total Due based on your option selected.
Sign and return the enclosed Statement of Applicant's Contract Anticipated Costs (SACAC) [Form 79-1003] (explanation in box to the right).
Please provide your payment and required forms within 90 days from December 24, 2024. PG&E is not bound by the costs set forth above if payment and the signed forms are not received by PG&E within 90 days.
If you have any questions, please contact Scott Lee
at 650-730-3696 or by email at [email protected].
ADDITIONAL INFORMATION
What is the SACAC form
Under PG&E's rules 15 and 16 you have a choice:you can
perform the work yourself, hire a qualified contractor to perform the work or hire PG&E to do the work. We are
required by the CPUC to provide you with PG&E's costs.
This form identifies our cost for the refundable service that is PG&E's responsibility to install. PG&E's costs were
developed based on your choices within the application and may change if you change that choice.
How do I fill out the SACAC?
If you want to do this work yourself or have a qualified contractor do this work, please enter your estimated costs in the section of the SACAC form entitled "Applicant Costs" or check the box in the section entitled "Applicant's Election Not To Provide Costs," sign and return to PG&E. PG&E will send you a revised agreement by return mail only if you choose to provide your estimated costs.
If you want PG&E to do this work, please check the section "Applicant's Election Not to Provide Costs," sign and return the SACAC form along with a check for the Total Due
based on the option you selected above.
You must return the completed SACAC form to PG&E
regardless of who you choose to do the work.
Please follow payment instructions
found on your Payment Coupon.
I,__________________________________ (Applicant), hereby attest and certify that this project does not meet the definition of Mixed- Fuel New Construction as described in PG&E Gas and Electric Rules 1 and 15, provided below:
MIXED-FUEL NEW CONSTRUCTION: A new end-use load or consistent with the definition of New Construction in the CEC 2022 Building Energy Efficiency Standards, a building that has never been used or occupied for any purpose, or any renovation where 50 percent or more of the exterior weight bearing walls are removed, that uses gas and/or propane in addition to electricity.
Pacific Gas and Electric Company
This contract has been reviewed and approved by:
Jay Min
Service Planning Supervisor
Customer
Agreed and accepted by:
City of Foster City, A GOVERNMENT AGENCY
Authorized Signatory Stefan Chatwin
Title City Manager
Signature #sigMLX#
Date #sigDateMLX#
#titleMLX#
#Form 79-1169#
128466864
STATEMENT OF APPLICANT'S CONTRACT
ANTICIPATED COSTS.*
Foster City Recreation CenterProject Name:
650 SHELL BOULEVARD, FOSTER CITYProject Location:
128466864Notification Number:
PM Number(s): (Gas) 35596775(Electric)
APPLICANT COSTS
The following statement must only include the contracted anticipated installed costs of facilities installed by the Applicant that are refundable and that are PG&E's responsibility under its tariffs.
The costs provided by the Applicant must be taken from the Applicant's contract with its contractor. If the Applicant will be performing the work itself, the Applicant must also complete and sign this form.
The Applicant's statement of costs will be compared with PG&E's estimated installed costs of the same facilities, the lower of which will be used to determine the amount subject to allowances and refunds in accordance with the provisions of PG&E's Gas and Electric Rules 15 and 16.
If the Applicant chooses not to provide its costs, it must complete the last section of this form. Until the Applicant either provides the refundable cost from its contract with its contractor (or its own cost, if applicable), or returns this form indicating that it will not do so, PG&E will not proceed with any work on the Applicant's project.
· Applicant's statement of costs include: overhead or underground service conductors,poles, service transformers, connection fittings, service pipe, valves, service connections,and other PG&E-owned service equipment, as detailed in Gas and Electric Rule 16.
· Applicant's statement of costs DOES NOT include: inspection fees, nonresidential service costs, regulators, or PG&E-owned metering equipment.
Form 79-1003
Advice 4350-G/6050-E
February 2021
†Information collected on this form is used in accordance with PG&E's privacy policy. The privacy policy is available at pge.com/privacy Automated document, Preliminary Statement, Part A
GAS ELECTRIC
Residential Service Facilities: Residential Service Facilities:
#applicantCostGas#Applicant: $ #applicantCostElec#Applicant: $ $0.00 PG&E: $0.00 PG&E:
0Number of gas service: 0Stubs: 0Number of Electric service:
#Form 79-1003#
December 24, 2024
* This form at all times shall be subject to such modifications as the California Public Utilities Commission May direct form time to time in the exercise of its jurisdiction.
128466864
GAS ELECTRIC
Gas Distribution Facilities
and Non-Residential Service Services:
Electric Distribution Facilities
and Non-Residential Service Services:
#gasDistFacilities#Applicant: $ #elecDistFacilities#Applicant: $ $0.00 PG&E: $55,145.02 PG&E:
GAS DISTRIBUTION TRENCH
#gasDistTrench#Applicant: $
$0.00 PG&E:
· Applicant's statement of costs include: overhead or underground service conductors,poles, service transformers, connection fittings, service pipe, valves, service connections,and other PG&E-owned service equipment, as detailed in Gas and Electric Rule 16.
· Applicant's statement of costs DOES NOT include: inspection fees, nonresidential service costs, regulators, or PG&E-owned metering equipment.
I declare under penalty of perjury that the foregoing is true and correct.
APPLICANT'S ELECTION NOT TO PROVIDE COSTS: (if this option selected, box must be checked) I choose not to provide to the utility my refundable costs for this project as taken from my contract with my contractor, or as performed by myself, and acknowledge that PG&E will use its estimate of the refundable costs for this project in the contract between it and me. #signDateSACAC#Executed on at
(Date) (City)
By:
City of Foster City, A GOVERNMENT AGENCYPrint Applicant Name:
#sigSACAC#Signed:
City ManagerTitle:
#titleSACAC#
Form 79-1003
Advice 4350-G/6050-E
February 2021
†Information collected on this form is used in accordance with PG&E's privacy policy. The privacy policy is available at pge.com/privacy Automated document, Preliminary Statement, Part A
#applicantSACAC#
Stefan Chatwin
Cost Breakdown
1Total number of combined meters:
1Total number of non-residential lots/units for this project:
0Total number of residential lots/units for this project:
Cost of Services:
$0.00 Engineering & Administrative Costs
Inspection Fees $0.00 (+)
Others (N/A) $0.00 (+)
Electric Metering $0.00 (+)
Service Tie-In Cost (Energized) by PG&E $0.00 (+)
Including Applicant Design Value of $0.00
$0.00 (+)Service Cost - Applicant installed 0# Services $0.00 (+)0# ServicesService Cost - PG&E installed
$0.00 (=)Total Estimated Cost of Service Subject to Allowance Cost of Service Within Allowance:
less Total Residential Service Allowance
(not to exceed Total Estimated Cost of Service Subject to Allowance) Excess Service Cost
Estimated Service Cost Within Allowance (Total less Excess) Average Cost per Lot or Unit Within Allowance
Excess Service Allowance Applied to Distribution Line Extension Refundable Amount per Lot or Unit:
Applicant: Stefan Chatwin
Project Location/Name 650 SHELL BOULEVARD, FOSTER CITY
$0.00 0X $0.00 (-)=
$0.00 =0/ $0.00
$0.00 (=)
$0.00 (=)
$0.00
Allowance
- $0.00
Ave. Cost / Unit
$0.00 =
Service Tie-in Cost by Applicant $0.00 (+)
**
Including Net Joint Pole Credit Value of $0.00
December 24, 2024
Pacific Gas and Electric Company
Detailed Cost Sheet - Electric Distribution
and Service Extension Costs
References
Notification # 128466864
Contract # 50115291 V1
E15-PM # 35596775
E16-PM # 35596775
E-Prior MLX/PM # 264586
Customer # 4529160
000128466864 Page 2 of 4
Allowances
Residential:
Amount Subject to Refund
$13,916.21Engineering & Administrative Costs
Including Applicant Design Value of $0.00
Tie-In of Distribution by PG&E $99,891.05 (+)
Electric Metering (Non-Residential Projects) $2,623.97 (+) Other Taxable charges ( N/A )
PG&E installed - Cost of Distribution Line and Non-Res Svcs.
Applicant installed - Cost of Distribution Line and Non-Res Svcs. $0.00 (+) $171,876.96 (=)
$0.00(+)Inspection Fees
SUB TOTAL
Total Refundable Amount $213,127.43 (+)
$0.00(+)
$55,145.02 (+)
$41,250.47 (+)24%plus ITCC @
$34,495.19 (-)Less Total Allowances (not to exceed Total Refundable Amount) $178,632.24 Balance: Net Refundable Amount
10 Year Refundable Advance Option
Balance: Net Refundable Amount $178,632.24
$0.00Less Credit for Value of Applicant Design Work
Less Cost of Dist. Line Ext. and Non-Res Svcs. installed by Applicant Less Distribution Substructures by Applicant
Net 10 Year Refundable Advance Option Amount
Non-Refundable Discount Option
Balance: Net Refundable Amount
Less Credit for Value of Applicant Design Work
Less Cost of Dist. Line Ext. and Non-Res Svcs. installed by Applicant Less Distribution Substructures by Applicant
Net Non-Refundable Discount Option Amount
$0.00
$0.00
$0.00
$178,632.24
$178,632.24
$0.00
$0.00
$89,316.12
$0.00
Allowance
X 0
Lots / Units
$0.00 =
24%plus ITCC @ Residential Allowances $0.00 (+)
SUB TOTAL Residential Allowances $0.00 (=)
Non-Residential: $4,106.04
Net Annual Revenue
/ 0.1476
Cost-of-Service-Factor
$27,818.69 =
24%plus ITCC @ Non-Residential Allowances $6,676.48 (+) SUB TOTAL Non-Residential Allowances $34,495.18 (=)
less Residential Service Allowance:
( 0
Lots/Units
X $0.00
Ave. Cost / Unit
) + 24%
ITCC
$0.00 =
Total Distribution Line Extension Allowance $34,495.18 (=) less Discount $178,632.24
Balance
X 0.50
Discount Rate
= $89,316.12 (-)
$300.71 (+)Value of Distribution Substructures
Including Net Joint Pole Credit Value of $0.00
$0.00(-)Less Non-Residential Service Costs not Qualified for Refunds $0.00(-)Less Distribution Extension Costs not Qualified for Refunds Non-Refundable Payments
Rule 16 Non-Refundable Payments
$0.00 (+)
$0.00
Service Costs Beyond Preferred Service Location
Excess Service Costs
$0.00 (+)Service Riser
Value of Service Trench, Conduits & Substructures in the Franchise Area or on 3rd Party Property
$0.00 (+)
$0.00 (+)Value of Rule 16 Land Rights Costs
$0.00 (+)
$0.00 (+)Cost of Additional Rule 16 Applicant Design Plan Checks Other Taxable Charges: N/A
$0.00 (+)
$1,146.80 (+)
Rule 16 Trench Permits Obtained by PG&E
Inspection Fees
$0.00(+)Plus Service Trench, Conduits, & Substructures installed by PG&E on Private Property
Inspection Fees (not subject to ITCC) $0.00(+)
$275.00 (+)1 unit(s)Non-Residential Per Meter Charge
Residential Per Meter Charge = 0 unit(s) $0.00(+)
$0.00 (+)Other Non-taxable Charges:
24%Plus ITCC @ $275.23 (+)
Total Rule 16 Non-Refundable Amount $1,697.03 (=)
Less Service Trench in the Franchise Area or
on & 3rd Party Property installed by Applicant
$0.00(-)Less Rule 16 Applicant Design Work Associated with Excess $1,146.80 (=)SUB TOTAL
000128466864
Inspection Fees $0.00 (+)
Re-estimating/Composite Preparation $0.00 (+)
Cost of Additional Applicant Design Plan Checks $0.00 (+) Value of Distribution Conduits $0.00 (+)
Distribution Risers Installed by PG&E $0.00 (+)
Value of Distribution Trench $0.00 (+)
PG&E Land Rights Costs $0.00 (+)
Rule 15 Trench Permits Obtained by PG&E $500.00 (+)
Other $0.00 (+)
SUB TOTAL $500.00 (=)
24%Plus ITCC @ $120.00 (+)
Other Non-taxable Charges $0.00 (+)
SUB TOTAL $620.00 (=)
Less Cost of Distribution Line Extension Installed by Applicant $0.00 (-) Less Distribution Substructures by Applicant $0.00 (-) Less Rule 15 Applicant Design Work $0.00 (-)
Less Distribution Conduits Installed by Applicant $0.00 (-) Less Distribution Trench Provided by Applicant $0.00 (-) Total Non-Refundable Electric Rule 15 Amount $620.00 (=) $0.00(-)
$0.00(-)Less Service Costs Beyond Preferred Location by Applicant $0.00(-)Less Excess Service Facilities Installed by Applicant SUB TOTAL $1,697.03 (=)
$0.00 (+)Non-Residential Service Costs not Qualified for Refunds $0.00 Distribution Extension Costs not Qualified for Refunds Rule 15 Non-Refundable Payments
Relocation/Rearrangement Inspection Fees
Relocation/Rearrangement Trench Permits Obtained by PG&E Value of Relocation Applicant Design Work
Tie-in/Meter of Relocation/Rearrangement by PG&E
Relocation/Rearrangement Land Rights
D.0405055 Line Extension Costs - Non-Residential (PMC Charge) Plus Relocation/Rearrangement - Non Taxable
D.0405055 Line Extension Costs - Residential (PMC Charge)
SUB TOTAL
Relocation / Rearrangement of PG&E Facilities
Actual Cost Billing Forecast(6)
$0.00(+)
$0.00(+)
$0.00(+)
$0.00(+)
$0.00(+)
$0.00(+)
$0.00(+)
0%Plus ITCC @ $0.00(+)
$0.00(=)
$0.00(+)
000128466864
Re-engineering/Comp Prep/Add'l AD Plan Checks $0.00 (+) Value of Relocation/Rearrangement Facilities $0.00
Value of Relocation/Rearrangement Conduits & Substructures $0.00 (+) Value of Relocation/Rearrangement Trench & Excavation $0.00 (+) Engineering & Administrative Costs $0.00 (+)
$0.00 (=)Total Relocation / Rearrangement of PG&E Facilities Amount $0.00(-)Less Relocation/Rearrangement Salvage
$0.00 Including Net Joint Pole Credit Value of
Less Value of Relocation Applicant Design Work $0.00(-) Less Trench & Excavation Provided by Applicant $0.00(-) Less Conduits & Substructures Installed by Applicant $0.00(-) SUB TOTAL $0.00(=)
Less Relocation/Rearrangement Facilities Installed by Applicant $0.00(-) Value of Electric Facility Reinforcements by based upon Applicant's estimated demand of: kVa
(Reference: Payment Adjustments. Excess Facilities section of provisions) $0.00 PG&E:
0.00 (1) Total Service Allowance not to exceed the Cost of Service (2) 10 Year Refundable and Discount Option credit amounts will be paid upon acceptance of facilities. Credit amounts are subject to future deficiency billing in accordance with the tariff. (3) 10 Year Refundable and Discount Option credit amounts do not offset Other Non-Refundable or Relocation Fees. See Reimbursement Summary for a total of Reimbursements and Credits to be paid upon acceptance of facilities. (4) Inspection Fees (Only Refundable if Applicant's Actual Cost is Used. Applicant's Actual Cost + Inspection Cannot Exceed PG&E's Estimate)
(5) The lower of PG&E's estimated costs or the Applicant's Contract Anticipated Costs (as documented on Form 79-1003 "Statement of Contract Anticipated Costs") will be used to establish the cost of Service and Distribution Line Extension subject to Allowance (6) Per CPUC Decision 23-12-037, Actual Cost Billing Forecast is to cover any cost increases due to unforeseen circumstances.
Total Non-Refundable Electric Rule 16 Amount $1,697.03 (+) Total Non-Refundable Electric Rule 15 Amount $620.00 (+) Total Non-Refundable Relocation / Rearrangement Amount $0.00 (+) Total Non-Refundable Costs $2,317.03 (+)
Actual Cost Billing Forecast Fee $0.00 (+)
Total Non-Refundable Payment $2,317.03 (=)
Note: This supplemental detailed cost sheet is for reference only and is not intended for use in place of the actual contract for the project listed.