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Oregon Department of Trenspartatian <br /> I ~i ~ ~ ~ PAGE N0. 1 <br /> BILLING DATE <br /> 08/06/02 19:24 <br /> REPORT NO. <br /> FMBL824-1 <br /> TO ENSURE PROPER CREDIT, RETURN A COPY OF THIS FORM WITH YOUR REMITTANCE T0: <br /> OREGON DEPARTMENT OF TRANSPORTATION <br /> 355 CAPTTOL 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 /> I ~ <br /> AGENCY T/C CURR. DOC. DDC. PATE VENpOR N0./SUFFIX UNIT <br /> 73 350 0000132900-84 9901 <br /> REVENUE AGENCY <br /> ACCOUNT SOURCE SOURCE AMOUNTMDUE AMOUNT REMITTED REV REFERENCE <br /> RVF13470-000 O1 $44010 22 268.14 17608 - CON <br /> y,. <br /> E -x ~t <br /> ~&'~~6 ~~~t,F4~ .a~t'~SE~Yfi'(rmd°a.'J~zs e°~SA #~a~~~ <br /> AMOUN ~ DUE <br /> <br /> 734-1158A(11-88) <br /> <br />