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CONTRACT FEE SECTION <br />PREVAILING WAGE RATE UNIT <br />BUREAU OF LABOR AND INDUSTRIES <br />$DD N.E. OREGON ST., #1045 <br />PORTLAND, OR 97232-2180 <br />PHONE: X971} 673-0852 <br />FAX: X971} 6730769 <br />For Office Use Unly: <br />Pro~eet DB #: <br />PUBLIC W[lRKS FEE INFORMATION FORM <br />For use by public agencies that have contracted with a contractor an a public works project regulated by <br />ORS 2790.800 to 2790.870, in compliance with ORS 2790.825. Also for use by public agencies that are a <br />party to a public works project pursuant to ORS 279C.8oD~6}~a}(B) or ~C}. <br />PUBLIC AGENCIES: Please complete and mail this form to SOLI at the above address, along with the public <br />works fee of one-tenth of one percent of the contract price contract amount x .0D 1 }, payable to B OLI. The <br />minimum fee is $25D.o0; the maximum fee is $7,5DD.D4. without the following completed information, the <br />bureau may be unable to properly credit you for payment received. <br />PUBLIC AGENCY: City of Eugene - En~ineerin~ .. AGENCY #: 1336 <br />AGENCY CONTACT PERSON: Lvnn Broaden ~ PHONE: X541) 682-5238 ____ <br />PROJECT MANAGER NAME: Chuck Mueller <br />MAILING ADDRESS: 244 E. Broadwa <br />PHONE; X541} 682-5295 <br />PROJECT NAME: Tonawanda Pum Station <br />CONTRACT NAME cif part of larger project): <br />PROJECT LOCATION: Lorane Hi hwa b80 feet west of Chambers Street <br />PROJECT NUMBER: 4544 <br />CONTRACTOR BUSINESS NAME ~DBA}: , H & J Construction Inc. <br />CONTRACTOR CCB#: $8084 <br />CONTRACT AMOUNT: $9a,D50.00 AMOUNT DUE: <br />Contract amount x .001 <br />.Please duplicate this form for future use} <br />53a- ~33a-C~«t~~{ -a~S~~S <br />~VH-39 Rev. 11!07} <br />~~~~~~ <br />DATE AWARDED: 9/12/2008 <br />~~~e <br />