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I ~ ~O ~ ~ ~ PAGE N0. 1 <br /> 1 ILLINO DATE'--- <br /> 11/04/03 20:13 <br /> CCOUNT N0. <br /> <br /> tom, SEE BELOW <br /> TO ENSURE PROPER CREDIT, RETURN A COPY OF THIS FORM WITH YOUR REMITTANCE T0: <br /> OREGON DEPARTMENT OF TRANSPORTATION <br /> 355 CAPITOL STREET NE, RM434 <br /> SALEM OR 97301-3872 <br /> i EUGENE, CITY OF <br /> GRANT ACCT PEGGY HAMLIN ~ FOR INFORMATION CONCERNING <br /> ~ 858 PEARL STREET THIS INVOICE CALL: <br /> EUGENE OR 97401 I (503)986-3879 <br /> I <br /> CV T/C CURR. OOC. DOC. DATE VENDOR N0./SUFFIX UNIT <br /> 73 350 52918 -00 9901 <br /> ACCOUNT NO . REVENUE "~"~y cusTnnER cusroMER REV cusronER <br /> SOURCE SOURCE AMOUNT DUE AMOUNT REMITTED REFERENCE <br /> ~tVF14i28-000_.01 84401.0. 22:. 886..46 14248-CON-E <br /> RVF13016-D00 :O1 8440L0 27., 1..,091.23.' 17483 - PE <br /> MOUNT DUE ;:=:=:5=:::::::':i:::3z:::>:::~ > >:<>:;$~~~'7., , 9 <br /> A . <br /> 7lf-115RR(11-R:) <br /> <br />