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City of Eugene <br /> Public Works Maintenance <br /> Public Works Parks and Open Space 444P41\11‘. <br /> 1820 Roosevelt Boulevard <br /> Eugene, OR 97402• Eugene <br /> Tele # (541) 682-4800 <br /> Fax # (541) 682-4882 <br /> RECEIPT <br /> Date i 16- ` GC(% _ <br /> From <br /> Address /1.1-0-K ,L' :-.74iot( <br /> City/State/Zip <br /> Quantity Description Amount <br /> i,�11 L�(r��� 13(C, t"c <br /> &cc . 91-170, , / 31 ' 3114 <br /> TOTAL <br /> Payment: 0 Cash # ( -( ( 0 Credit Card <br /> Received by J�%c� � ; ��� c(o` vA4 <br /> 4� <br /> IWILLIAM ROSE WINES LLC 3066 <br /> D B A WILLIAM ROSE WINES n 96-50511232 <br /> PO BOX 50851 1/ 7 1\0` 1� 50050 <br /> EUGENE,OR 97405-0999 V 111 Date EIFRA1OAR" <br /> Pay to the C A $ 13oo <br /> Order of <br /> c �� � y�7 Dollars lel <br /> gUMPQUA <br /> BAN-K (11-866-4UMPAUA <br /> -866.486.7782) <br /> For svAP <br /> :l <br />