DATE
                                                                    PROJECT TYPE (Office Code)                               
                                                                    PROJECT RESPONSIBLE STAFF                              

PROJECT & SCOPE OF SERVICES
CLIENT CLIENT NO._______________________
ADDRESS
PHONE NO.  FAX
ORDER TAKEN BY ______________________ DATE REQUIRED
LOCATION OF WORK
LOTS BLOCK ADDITION
SECTION TOWNSHIP RANGE
CITY OF COUNTY OF STATE OF

SURVEY FIELD WORK

REMARKS (such as cors. to be set, kind, and other special info.)

PAPERS LEFT WITH US
NOTIFY (BEFORE) WHEN WORK IS TO BE DONE.

FEES:
Fees for all services outlined above will be charged on an hourly basis at the rate of 2.00 times Payroll cost of staff members working on your project plus Reimbursable Expenses.  For planning purposes, the estimated Fees are as follows:
                                LABOR COST ESTIMATE                   $ _______________________
                               REIMBURSABLE COST ESTIMATE        $ _______________________
                                TOTAL PROJECT COST ESTIMATE      $ _______________________
Conditions encountered may result in higher or lower charges.

TERMS AND CONDITIONS:
To assure a clear understanding of all matters related to our mutual responsibilities, the Standard Terms and Conditions on the back of this page are made as a part of this agreement for our services.

ACCEPTANCE:
The above Scope of Services, Fees, and Terms and Conditions are satisfactory and hereby accepted.  You are authorized to do the work.
_____________________________________        ____________________________________________
Signature of Client                                                 Date of Acceptance
Project No. __________________________________
Client return White Copy and one copy of Survey Addendum, Keep yellow copy and second Copy of Survey Addendum.

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Copyright © 1998 Klingner & Associates. All rights reserved.
Revised: February 07, 2007.