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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 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 -Engineering AGENCY #: 1336 <br />AGENCY CONTACT PERSON: Lynn Brogden PHONE: (5412 682-5560 <br />PROJECT MANAGER NAME: Adam Steffen PHONE: (541) 682-5040 <br />MAILING ADDRESS: 244E Broadway <br />PROJECT NAME: Videra Park Improvements at 2727 Blacktail Drive <br />CONTRACT NAME (if part of larger project): <br />PROJECT LOCATION: 2727 Blacktail Drive <br />PROJECT NUMBER: 4418 DATE AWARDED: 7/3/2008 <br />CONTRACTOR BUSINESS NAME (DBA): Wildish Construction Co. <br />CONTRACTOR CCB#: 695 <br />CONTRACT AMOUNT: $119,735.50 AMOUNT DUE: ~ J <br />Contract amount x .001 <br />(Please duplicate this form for future use) <br />t WH-39 (Rev. 11/07) <br />~~~ <br />~;~ <br />`~~ ~ '~"~ <br />d ,. ^^ _ <br />~~ 0.e ~ ~ ~`~ a `? . r . <br />1 j ~~ <br />" ~ , ~, <br />~..~ <br />i ~-.~ <br />