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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: (971) 673-0852 <br />FAX: (971) 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.800 to 279C.870, in compliance with ORS 279C.825. Also 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 BOLI 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 BOLI. 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 of Eugene - En ing Bering AGENCY #: 1336 <br />AGENCY CONTACT PERSON: Lynn Brogden PHONE: (541) 682-5238 <br />PROJECT MANAGER NAME: Chuck Mueller PHONE: (541) 682-5295 <br />MAILING ADDRESS: 244E Broadway Eugene OR 97401 <br />PROJECT NAME: Delta Ponds Boardwalk off Goo~asture Island Road <br />CONTRACT NAME (if part of larger project): <br />PROJECT LOCATION: Delta Ponds off Goodpasture Island Road <br />PROJECT NUMBER: 4559 DATE AWARDED: 8/4/2008 <br />CONTRACTOR BUSINESS NAME (DBA): 2G Inc. dba 2G Construction <br />CONTRACTOR CCB#: .40559 <br />CONTRACT AMOUNT: $230,674.35 AMOUNT DUE: <br />~~~ ~ ~ <br />Contract amount x .001 <br /> <br /> <br />® (Please duplicate this form for future use) <br />®AYE <br />INDITIALS• <br />WH-39 (Rev. 11/07) <br />5/_211 _ <br />~lizLo g <br />_.__ __.._Tc1,S <br />~~c a~:~~- ~-~y ~~~-l~~z <br />