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CONTRACT FEE SECTION <br />PREVAILING WAGE RATE UNIT <br />BUREAU OF LABOR AND INDUSTRIES <br />800 N.E. OREGON ST., #1045 <br />PORTLAND, OR 97232-2180 <br />PHONE; X971} 673-0852 <br />FAX: 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 an a public works project regulated by <br />ORS 279C.800 to 279C.870, in compliance with ORS 279C.825. Alsv for use by public agencies that are a <br />party to a public works project pursuant to ORS 279C•800(6}~a}~B} or ~C}. <br />PUBLIC AGENCIES: Please complete and mail this form to B~LI~ at the above address, along with the public <br />works fee of one-tenth of one percent of the cantract price (contract amount x .001), payable to BULI. The <br />minimum fee is $250.00; the maximum fee is $7,500.00. Without the following completed information, the <br />bureau may be unable to properly credit you for payment received. <br />PUBLIC AGENCY: City ofEugene - En~ineer~n~ AGENCY #: 1336 <br />AGENCY CONTACT PERSON: L nn Bro den PHONE: X541) 682-5238 _ ____ <br />PROJECT MANAGER NAME: Matt Rodrigues .._ ._.,~._ PHONE: X541) 682-6036 <br />MAILING ADDRESS: 244 E. Broadwa <br />PROJECT NAME: 2008 Pavement Preservation Pro ram-Roosevelt Blvd, from Beltline Hi hwa to Chambers <br />Connector Federal Aid Pro'ect #X-STP-2385 058 <br />CONTRACT NAME cif part of larger project}: <br />PROJECT LOCATION: Roosevelt Blvd. from Beltline Hi hwa to Chambers Connector <br />PROJECT NUMBER: 4479 <br />CONTRACTOR BUSINESS NAME (DBA): Eu ene Sand Construction Inc. <br />CONTRACTOR CCB#: 177967 <br />CONTRACT AMOUNT: $1,677,137.85 AMOUNT DUE: ~ ~ ~ ~ + 10 <br />Contract amount x .001 <br />Please duplicate this form for future use) <br />DATE AWARDED: 9/12/2008 <br />