Cogbill, James R.Backflow Tester Registration
Date *
Te ste r Name *
Name of Company *
Addre ss *
Office Phone
Numbe r *
M obile Phone
Numbe r
Email Addre ss *
Inv oice Numbe r
Registration is good for one year from the date of registration.
Once your information has been entered into our system, you will receive an email with your Invoice number. You will
need this Invoice number to pay for your registration on line at:
https://e ne rgovprodweb.coppelltx.gov/Ene rGov_Prod/Se l fSe rvi ce #/home
Cit y of Cop pell P ub lic W orks Dep t .
816 S. Co pp ell Rd ., S uite 103
Co pp ell, TX 75019
972-462-5150
9/17/2018
James R. Cogbill
AGR Plumbing Services & Repair
City
Hurst
State / Province / Region
TX
Postal / Zip Code
76053
Country
USA
Street Address
P.O. Box 2128
Address Line 2
1220 W. Hurst Blvd., Suite 100
8173791481
8,178,793,586
j.cogbill@att.net
INV-00011859
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BILLING CONTACT �
James Cogbill •
AGR Plumbing Service& Repair �• .��
Po Box 2128 •
Hurst, Tx 76053 •
INVOICE NUMBER INVOICE DATE INVOICE DUE DATE INVOICE STATUS INVOICE DESCRIPTION
INV-00011859 09/17/2018 09/17/2018 Paid In Full NONE
REFERENCE NUMBER FEE NAME TOTAL
Misc Fee Backflow Contractor Registration $75.00
SUB TOTAL $75.00
REMITTANCE INFORMATION TOTAL $75.00
City Of Coppell
P.O. Box 9478
Coppell, TX 75019
September 24,2018 255 Parkway Boulevard, Coppell Texas 75019 Page 1 of 1
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