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EXHIBIT I <br />CITY OF ELK RIVER <br />COPY COST CALCULATION FORM FOR SPECIAL RATE <br />INSTRUCTIONS: Use this SPECIAL RATE form when the cost of providing copies exceeds the FLAT RATE. <br />REQUEST DATE <br />REQUESTER NAME <br />OF INFORMATION <br />El The following calculations represent the ACTUAL COST of providing copies. <br />EJ The following calculations represent the ESTIMATED COST of providing copies. <br />(If the estimated cost of providing copies is $50. 00 or ore, the requester must pay <br />at least 50% of the estimated cost before compiling, certifying and/or making copies.) <br />SPECIAL RATE <br />A. Labor: <br />(NO. OF HRS.) <br />(NO. OF HRS.) <br />B. Photocopy: <br />I <br />(HOURLY RATE) <br />X — <br />(HOURLY RATE) <br />X <br />(PHOTOCOPY RATE) (NO. OF PAGES) <br />C. Mailing: <br />D. Publication Printing Cost: <br />E. Other costs, describe: (To include computer time, programming time, terminal <br />access, microfilming systems and any other costs not listed above.) <br />1. <br />2. <br />3, <br />4. <br />ESTIMATED <br />COST <br />ACTUAL <br />COST <br />AMOUNT TO BE PREPAID <br />TOTAL CHARGES <br />$ <br />AMOUNT TO BE PREPAID <br />(50% of EST. TOTAL if $50 or over) <br />$ <br />AMOUNT DUE <br />(Upon completion of copying) <br />$ <br />PREPARER NAME I DEPT/DIV I DATL <br />