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G 7 C)0 '6u -1 / / 5 0 - Ad <br /> -: _ coo o v <br /> Oregon Department of Consumer and Business Services y 5 <br /> Oregon Occupational Safety and Health Division (OR -OSHA) ;, <br /> 1140 Willa illes ie, Suite 42'w <br /> Eugene, OR 97401 <br /> Phone: (541)686 -7562 <br /> INVOICE/ <br /> DEBT COLLECTION NOTICE • <br /> Company Name: City of Eugene <br /> Inspection Site: 1820 Roosevelt Blvd, Eugene, OR 97402 <br /> Issuance Date: 05/08/2006 <br /> Summary of Penalties for Inspection Number 309420131 rj CO <br /> Citation 1, Serious = $ 1250.00 <br /> C <br /> Citation 2, Other = $ 250.00 • <br /> «L, ?. <br /> 6 1 69 3z- <br /> RETURN COPY OF INVOICE WITH PAYMENT <br /> Oregon Revised Statutes, Chapter 654, the Oregon Safe Employment Act, Subsection 654.086(3) states: When <br /> an order assessing a civil penalty becomes final by operation of law or an appeal, unless the amount of penalty is <br /> paid within 10 days after the order becomes final *, it constitutes a judgment and may be filed with the county clerk <br /> in any county of this state. The clerk shall thereupon record the name of the person incurring the penalty and the <br /> amount of the penalty in the judgment docket. The penalty provided in the order so docketed shall become a lien <br /> upon the title to any interest in property owned by the person against whom the order is entered, and execution <br /> upon a judgment of a court or record." *(Final order is defined as 20 days after receipt of the citation, unless it <br /> is appealed.) <br /> To avoid additional charges, please remit payment promptly to Department of Consumer & Business Services, <br /> Fiscal Services Section, Labor & Industries Building, PO. Box 14610, (350 Winter St NE) Salem, Oregon 97309- <br /> 0445, for the total amount of the uncontested penalties summarized above. Make your check or money order <br /> payable to: "DEPARTMENT OF CONSUMER & BUSINESS SERVICES. " Please indicate the Inspection Number <br /> (printed above) on the remittance and return a copy of this invoice with payment. <br /> Mail your payment to: DEPARTMENT OF CONSUMER & BUSINESS SERVICES <br /> Fiscal Services Section - OR -OSHA <br /> PO Box 14610 <br /> Salem OR 97309 -0445 <br /> Employer ID #: 5723077 -012 Fiscal use only 51101 0345 <br /> Company Name: - City of Eugene <br /> Opt Rpt Num: M1454- 025 -06 <br /> Region ID #: 1054114 <br /> [ Page 1 of I1 • <br /> CcLi c_ -/3 <br />