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~ ~ ~ 179 <br /> INDUSTRIAL PHONE DATEbFORDER' <br /> CONCRETE COATINGS INC. <br /> ~.0. ~ox'699 24759 LaVeII Rd. ORDER TAKEN BY CUSTOMERbRDERNUMBER <br /> JIJN~TION CITY, OREGON 97448 <br /> CCB#49848 <br /> (541 998-3407 DAY WORK X CONTRACT EXTRA <br /> FAh( (541) 998-8166 <br /> ~ 1t~7 Of Eugene JOB NAME /NUMBER <br /> ttention Accounts Payable Installation Of 2 Plaq~eg <br /> 58 Pearl Street, Suite 300 JOB LOCATION <br /> Eugene OR 97401 DeFazio Brid e And Ferr ri <br /> JOB PHONE STARTING DA7E <br /> f _ <br /> • <br /> l0 5'1 ~ C',~~? Q~'~ <br /> q~ 50'~'~ <br /> RE 3~2 q~,32 <br /> DA E `{-Z-oi_ <br /> 11111. IAL C <br /> • o.oo <br /> Contract Price 1,165.00 <br /> • • 1, 165.00 • ~ ~ 0.00 <br /> • • • <br /> Install two plaques. One on Ferry St. Bridge and one on the DeFazio Bridge. <br /> v~L ~~I a Z <br /> l~- ~ <br /> TERMS DATE COMPLETED 0 Q ~ <br /> • <br /> Upon Invoice, Net 10 Days 3/23/2001 • ~ • 1,1&5.00 <br /> '`RK ORDERED BY • ~ ~ " • 0.00 <br /> <br /> i~ Diane Bishop 0.00 <br /> AUTHORIZED SIGNATURE <br /> TOTAL' 1, 16 5. 0 0 <br /> I hereby acknowledge the satisfactory completion of the above described work. <br /> PPODUCT 13/P3T FOLD AT TO FIT COMPANION 771 DU-O•VUE ENVELOPE. PRINTED IN U.S.A. B <br /> <br />