Charles Jestis City of Coppell, TX
Public Works
255 Parkway Blvd, Coppell, TX 75019
Coppell, TX 75019
972-304-3500
Welcome
002381-0001 Debbie T. 02/08/2019 01 : 03PM
ENER60V INVOICE
Jestis, Charles (Classic Backflow, LLC)
2019 Item: INV-19-00015290
Balance due: 0. 00
Balance unpaid: 0 . 00
Backflow Contractor �
Registration 75. 00
Payment Id: 12645
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75. 00
Subtotal 75. 00
Total 75.00
CREDIT CARD - UTILITY OPS 75 . 00
MdsterCdrd *********F**6926
Ref=3050248701
Auth=01737G
20190208259A
AID=A0000000041010
Invoice=78200620190208130325
AuthCode=01737G
Entry=Chip Read
AppLabel=MASTERCARD
ATC=0031
Seq=78200620190208130325
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Change due 0.00
Paid by: Jestis, Charles (Classic
Backflow, LLC)
Signature:
Thank you for your payment
CUSTOMER COPY
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BACKFLOW REGISTRATION FORM
Registration is for one year from the date of registration or r�registration.
Date of Registration: 2/08/2019
Name: Charles Jestis
Company: Classic Backflow, LLC
Mailing Address: 3025 Oak Meadow Dr, Flower Mound, Texas 75028
(Street&Number/PO Box,City,State and Zip)
Physical Address: 3025 Oak Meadow Dr, Flower Mound, Texas 75028
(Street&Number,City,State and Zip)
Office Phone Number: 214-535-3341
Mobile Phone Number: 214-535-3341
E-mail Address: cjestis88@gmail.com
City of Coppell Public Works Dept.
816 S. Coppell Road
Coppell,TX 75019
972-462-5150
www.coppelltx.gov