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Y ~ ' fir/ ~ _ PAGE NO. 1 <br /> ILLING DATE <br /> 06/30/04 21:20 <br /> <br /> . (COUNT NO. <br /> SEE BELOW <br /> TO ENSURE PROPER CREDIT, RETURN A COPY OF THIS FORM WITH YOUR REMITTANCE T0: <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 /> GENCV T/C CURR. DOC. pOC. DATE VENDOR N0./SUFFIX UNIT <br /> i <br /> 73 350 0000132900-84 9901 <br /> ~ ACCOUNT NO . REVENUE ~6ENCY CUSTOMER CUSTOMER CUSTOMER <br /> SOURCE SOURCE AMOUNT DUE AMOUNT REMITTED REV REFERENCE <br /> RVF14825-000 D1 844010' 22 30,OIb.01 17483 - CON <br /> :-n, <br /> ~ ;~a ~ E i, u~°~er H~ <br /> ~ p~sr+~~`~°`~' ~E1 u~ gad ~ ~ ~~.g~t~ ye`b~t~(~~g~~~P <br /> <br /> ~I'' <br /> <br /> I, <br /> AMOUNT DUE _ $30,' 6.>Q i <br /> 734-1150~Q1-88) - <br /> <br />