CITY HARVEY PUBLIC WORKS Payment

CITY HARVEY PUBLIC WORKS

Board-Up Service Payment Form

INSTRUCTIONS: Compete the fields below, confirm the correct Invoice No. and Invoice Total has been entered before clicking Pay Now. Any unpaid balance shall be subject to a 10% late penalty. All payments are non-refundable. THANK YOU.

Phone

Business or Resident Full Name

Full Mailing Address

Full Service Address

Invoice No.

Card Details

Cardholder Name

Credit Card Number

Expiration Date

CVV

Billing Address

Address

City

State or Territory

ZIP Code