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C)reyon Def:artr, <br /> Ient of Transportation <br /> ~1 ~O ~ ~ ~ PAGE N0. 1 <br /> ILLING DATE <br /> 03/02/04 20:51 <br /> i <br /> CCOUNT NO. <br /> SEE BELOW <br /> i <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 /> j OST-CITY OF EUGENE PUBLIC WORKS <br /> 'LGIP ACCOUNT #4909-PEGGY HAMLIN FOR INFORMATION CONCERNING <br /> j ;858 PEARL 4TH FLOOR THIS INVOICE CALL: <br /> ~ EUGENE OR 97440 (5.03)986-3879 <br /> j <br /> GENCV 7/C CURR. DOC. DOC. DATE VENDOR NO./SUFFIX UNIT <br /> 73 350 0000132900-84 9901 <br /> REVENUE AGENCY CUSTOMER CUSTOMER CUSTOMER <br /> ACCOUNT NO . SOURCE SOURCE AMOUNT DUE AMOUNT REMITTED REV REFERENCE <br /> RVF14825-OOD 01 84401.0.. 22 25,016.00 ~hteti~ ~f4~ta~ 17483 - CON <br /> <br /> ,i <br /> AMOUNT.. DUE <$25 . 00 <br /> , <br /> 734-115UA(11-86) <br /> <br />