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STATE OF OREGON REMITTANCE ADVICE <br /> TO SIGN UP FOR DIRECT DEPOSIT PAYMENT SERVICE AND RECEIVE CONVENIENT, ELECTRONIC <br /> INTERNET. LOG IN TO <br /> CLICKONF <br /> FORMS AN W <br /> AND BROCHURES. ES <br /> . THENS <br /> SELECT DIREC / <br /> T DEPO <br /> DEPOSIT ON THE <br /> CH) <br /> AUTHORIZATION FORM. <br /> WARRANT NO. <br /> 123638694 <br /> MILITARY DEPT (503) 584 -3878 EXT. <br /> INVOICE NO. INVOICE DATE INVOICE DESCRIPTION AGY DOCUMENT AMOUNT <br /> DR4169, PW 22 062614 FEMA DISASTER 4169 PW 22 248 VP374228 20,588.21 <br /> DR4169, PW 25 062614 FEMA DISASTER 4169 PW 25 248 VP374228 11,468.45 <br /> ISSUE DATE: WARRANT AMOUNT <br /> 07/22/14 32,056.66 <br /> VENDOR NAME: CITY OF EUGENE <br /> FOLD ON PERFORATION LINE BELOW D, BEFORE DETACHING. <br /> STATE OF OREGON To the State Treasurer, Salem, Oregon 96 -10 1< <br /> Dept of Administrative Services PAYABLE THROUGH US BANK 1232 by ; ** BANK WARRANT NO. <br /> CHECK DATE . =„ "��';c 12 3638694 <br /> MILITARY DEPT " t.h -,w,;_ 4 <br /> (503) 584 - 3878 EXT. 07/22/14 <br /> :PAY THIS AMOUNT <br /> VP374228 $32,056.66 <br /> * * * * * * * * * * * * * * ** *THIRTY TWO THOUSAND FIFTY SIX AND 66 /100 DOLLARS <br /> PAY TO THE ORDER OF: <br /> CITY OF EUGENE VOID 2 YEARS AFTER DATE ISSUED <br /> DEPT OF PUBLIC SAFETY <br /> 777 PEARL RM 107 ' <br /> EUGENE OR 97401 -2720 <br /> H V � AUT ED SIGNATURE <br /> II• L 2363E169411' I u■ <br />