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City of Eugene <br /> Public Works Maintenance <br /> Public Works Parks and Open Space ON <br /> 1820 Roosevelt Boulevard <br /> Eugene, OR 97402 Eugene <br /> Tele # (541) 682 -4800 <br /> Fax # (541) 682 -4882 # 1S7- 6 i33�- 4 -4 <br /> 1 RECEIPT <br /> Date `T I1((il { /9 - 7 <br /> From Yac(I 1-- - cIc -e_,• <br /> Address 9 U 4 Ic v 1 A 12 d• <br /> City /State /Zip 7 1u ,.A. c cc- 1 O R <br /> Quantity Description Amount <br /> Da' <br /> r "Ic ; I , <7!'t -rGh - �(nar,/ ht�ft(, - - • Wj kate... -tic. <br /> 9 ('G'. <a <br /> u , ka 0 - tea ! 4 ,2,e ,;i 1, ` 6 iv J <br /> TOTAL -, e5a. c c,) <br /> 7 <br /> Payment: Cash ❑ Check # ❑ Credit Card <br /> . <br /> ! 1 GA l 1_4 4 <br /> Received by _-. 4j. u- -1-' .. c.- 4- `6.?"- *'.2- J <br /> !_ D WRITE 4 8 '+ ABOVE THIS LINE A 5 5 5 A, <br /> 4 I <br /> 21 t 5 I + PLEASE DO NOT WRITE ABOVE THIS- <br /> T R S C Y A L EXPIRATION <br /> /� � � �J am � CLASS DESCRIPTION PRICE AMOUNT <br /> M I �' a �� L CHECKED �.l - . , 1 �� .......,• a v ` , 011 _.rte O 11 , 0. <br /> cO a 0 <br /> w 7 ' <br /> 71 0 <br /> 67453228 _J � N� <br /> N $ f C I t V Y F EUGENE O S AUTH ORIZATION SUB J z M EUGENE OR � � TOTAL /4/40' a <br /> Q ` t REFER NO. SERVER ' N w <br /> Y TAX ' g <br /> z • g l. <br /> m ID- FOLIO /CHECK NO. /LIC. NO. STATE REG. /DEPT. CLERK TIP <br /> a I MISC.. t <br /> I SIGN ,-, .... <br /> V/S4 MasterCar TOTAL cp <br /> �►�L.�.. � � ,.► ,�� 55529 <br /> I T o ard identi • on till- item is authorized �: y the a ount shown as TOTAL <br /> upon proper presentation I promise t pa s T ( ether with n other har <br /> thereon) subject to and in accordant with the a g overnin g the a use of succh card due <br /> 94 <br /> .__ 1 — - , -- .,-...—_____ <br />