New Search
0 <br />•.. .,. <br />~,_ to s <br />G-rJ~l.[ ~~ /U <br />regon <br />February 6, 2008 <br />CITY OF EUGENE <br />ENGINEERING DIVISION / BROGDEN <br />244 E BROADWAY <br />EUGENE, OR 97401 <br />Bureau of Labor and Industries <br />Brad Avakian <br />Commissioner <br />PAYMENT RECEIPT FOR PUBLIC WORKS FEE <br />(ORS 839-025-0210) <br />Name of Project: PAVEMENT PRESERVATION PROGRAM 2008 SLURRY SEAL#59406 <br />This certificate is proof the CITY OF EUGENE, ENGINEERING DIVISION/ BROGDEN <br />made a fee payment of $250 for the public works project named.above, based on the contract <br />awarded to ASPHALT MAINTENANCE ASSOCIATES INC (CCB#: 62952) on 06-JUN-08, <br />leaving a balance of $0 for this contract. <br />As required by ORS 279C.825 and OAR 839-025-0210, the agency shall, upon completion of <br />file contract, determine the final contract price, including change orders and adjustments to the <br />contract. If the final contract price varies by $1U0,000 or more, the agency shall submit any <br />additional payment or request for refund of fees, using form WH-40, to the bureau within 30 <br />days of fugal payment to the contractor by the agency. <br />PORTLAND EUGENE BEND MEDFORD <br />800 NE Oregon St. Suite 1045. 1400 Execuflv~ Parkway, Suite 200 Worksource Bend 119 N Oakdale Ave. <br />Portland, OR 97232 2180 Eugene, OR 974012158" 1645 NE Porbes Rd, Ste 106 Medford, OR 97501-2629 <br />Fax9 971) 673-0762 FAX (5)41.686-7980 ~ (54~ 322-2435~~~ FAX (5)4776-6284 <br />TTY (971} 673-0766 PAX (541)389-8265 <br />SALEM PENDLETON <br />3865 Wolverine St. NE; E-i 1327 SE Std St. <br />Salem, OR 97305-1268 Pendleton, OR 97801.4101 <br />(503) 378292 www.oregon.gov/boli (541) 276-7ss4 <br />FAX (503) 373-7636 p,N EQUAL OPPORTUNITY EMPLOYER FAX (541) 27fi-5767 J~~ ~ ~ ~Q~$ <br />