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CONTRACT FEE SECTION <br />PREVAILING WAGE RATE UNIT <br />BUREAU OF LABOR AND INDUSTRIES <br />$00 N.E. OREGQN ST., #1045 <br />'PORTLAND, OR 97232-21$0 <br />PHONE: X971} 673-0$52 <br />FAQ: X971} 673-0769 <br />For Office Use Only: <br />Project DB <br />PUBLIC WORKS FEE INFORMATION FORM <br />For use by public agencies that have contracted with a contractor on a public works project regulated by <br />ORS 279C.S00 to 279C.870, in compliance with URS 279C.825. Also for use by public agencies that are a <br />party to a public works project pursuant to ORS`'279C.$00~6}(a}(B} or ~C}, <br />PUBLIC AGENCIES: Please complete and mail this form to BALI at the above address, along with the public <br />works' fee of one-tenth of one percent of the contract price contract amount x .001}, payable to B4LI. The <br />minimum. fee is $250.40; the maximum fee is X7,500.00. ~1"ithout the following completed information, the <br />bureau maybe unable to properly credit you for payment received. <br />PUBLIC AGENCY: Cit of Eu ene - En ineerin ~ AGENCY #: 1336 <br />AGENCY CONTACT PERSON: L,, n~gden PHONE: S41 682-5238 <br />PROJECT MANAGER NAME: Scott Milovich ~ PHONE; 541 682-6086 <br />MAILING ADDRESS: 244 E. Broadwa Eu ene GR 97401 <br />PROJECT NAME: Delta Ponds Soil Amdendment and Seeedin <br />CONTRACT NAME if art of lar er ro'ect : Delta Ponds Ri arian Plantin 2009-12 Job #4572 <br />~ P g p J } <br />PROJECT LOCATION: Delta Ponds off of Good asture Road <br />~, <br />PROJECT NUMBER: Job ~ DATE AWARDED: 10/20/2008 ,.. <br />_, ~ <br />CONTRACTOR BUSINESS NAME ~DBA}: Elms Landsca e Services Inc. <br />CONTRACTOR CCB#: 6855 LCB ~~ <br />~: x~ <br />CONTRACT AMOUNT: 38 395.20 AMOUNT DUE: ;.. <br />h <br />Contract amount x .001 ~--- <br />~.. <br />Please duplicate this form for future use} <br /> <br />WH-39 (Rev. 1,1/07) <br />,'~ C <br />Vic; ~c~c t ~C~ ~ i z <br />i~~~ a5 ~o~ ~ <br />a ~l'~' c" ~~~°~~sY <br />