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Ore.~onUz~pa: -nt ofTransportation <br /> ~O ~ ~ ~ ~ PkGE NO. 1 <br /> ILLING DATE <br /> 10/05/04 21:19 <br /> CCGUNT ND. <br /> SEE BELOW <br /> TO ENSURE PROPER CREDIT, RETURN A COPY OF THIS FORM WITH YOUR REMITTANCE TO.: <br /> OREGON DEPARTMENT OF TRANSPORTATION <br /> 355 CAPITOL STREET NE, RM434 <br /> SALEM OR 97301-3872 <br /> OST-CITY OF EUGENE PUBLIC WORKS <br /> LGIP ACCOUNT #4909-PEGGY HAMLIN FOR INFORMATION CONCERNING <br /> 858 PEARL 4TH FLOOR THIS INVOICE CALL: <br /> EUGENE OR 97440 (503)986-3879 <br /> GENCY T/C: CURR. DOC. DDC. DATE VENDOR ND./SUFFIX UNIT <br /> 73 350 0000132900-84 9901 <br /> ACCOUNT NO . REVENUE "sE"`" CUSTOMER CUSTOMER REV CUSTOMER <br /> SDURCE SOURCE AMOUNT DUE AMOUNT REMITTED REFERENCE <br /> RVF14825=000 O1 '844010 >22 b0744.55 12483 = CON <br /> ~~a~ ~.~.r,~.go~~ ~E~~ ~~r~ f~ 6R~lN <br /> ~~~~e ~C~~ S~A~ ~~AS~1 AC n~NT <br /> AMOUNT DUE $6D~.4~+'55 ---~-~s'' <br /> - <br /> <br /> 734-1150"(11-88) t- <br /> <br />