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9l~onDe}~ar6nentofTiansportatioh <br /> i <br /> PAGE N0. 1 <br /> V0.1 ~ ~ ILLING DATE <br /> l <br /> j 06/30/05 20:38 <br /> (COUNT NO. <br /> <br /> 'i <br /> SEE BELOW <br /> TO ENSURE PROPER CREDIT, RETURN A COPY OF THIS FORM WITH YOUR REMITTANCE T0: <br /> ~ OREGON DEPARTMENT OF TRANSPORTATION <br /> i 355 CAPITOL STREET NE, RM434 <br /> SALEM OR 97301-3872 <br /> (EUGENE, CITY OF i <br /> GRANT ACCT PEGGY HAMLIN ~ FOR INFORMATION CONCERNING <br /> 858 PEARL STREET . THIS INVOICE CALL: <br /> t EUGENE OR 97401 (503)986-3879 <br /> 1 <br /> GENCY T/C CURR. DOC. DOC. DATE VENDOR NO./SUFFIX UNIT <br /> i <br /> 73 350 52918 -00 9901 <br /> ( REVENUE CUSTOMER CUSTOMER CUSTOMER <br /> ACCOUNT NO' SOURCE 80VRCE AMOUNT DUEAMOUNT REMITTED REV REFERENCE <br /> RVF1.7339-000 03 844010 21 14,40 20958 - PE <br /> RVF17271-000 O1 844010 21 24.69 ~ 22213 PE <br /> <br /> I~ <br /> AMOUNT DUE <br /> 734-1150(11-88) - <br /> <br />