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Oregon Deparfrnent pf Transportation ~ ~ ~ 212 <br /> J ~ I Y ~O ~ ~ ~ PAGE N0. 1 <br /> ILLING DATE <br /> 7J 08/04/99 23:25 <br /> ` n~n~~ f~~~ EPORT NO. <br /> Y V (J- FMBL824-1 <br /> TO ENSURE PROPER CREDIT, RETURN A COPY OF THIS FORM WITH YOUR REMITTANCE T0: <br /> OREGON DEPARTMENT OF TRANSPORTATION <br /> 434 TRANSPORTATION BUILDING <br /> SALEM OR 97301-3872 <br /> 'OST-CITY OF EUGENE PUB WORKS <br /> LGIP ACCOUNT #5485-JENNY LYNNES FOR INFORMATION CONCERNING <br /> <br /> 1 858 PEARL 4TH FLOOR ~ THIS INVOICE CALL: <br /> '.EUGENE OR 97401-2795 ~ (503)986-3956 <br /> GENCY T/C CURR. DOC. DOC. DATE VENDOR N0./SUFFIX UNIT <br /> i <br /> 73 350 13291 -63 9901 <br /> ~ ASENCY <br /> REVENUE CUSTOMER CUSTOMER CUSTOMER <br /> ACCOUNT SOURCE SOURCE AMOUNT DUE AMOUNT REMITTED REV REFERENCE <br /> RVF10229,-000. O1 <844(}10 22 -8~-a9- a 7~; 6S"~ 11796 - CQN <br /> I, <br /> -~O r. h a~ ~vlK ifs `i. <br /> 3 < 9' <br /> I <br /> . _ <br /> i <br /> AMOUNT DUE <iV0 REMITT'Ai~1~E REQ~IIRft7 <br /> 734-1i50A(11-88) <br /> <br />