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07~egon Department of Tnrsportation <br /> ' ~ ! l~ ~ ~ ~ PAGE N0. 1 <br /> BILLING DATE <br /> 07/01/99 1:09 <br /> EPORT NO. <br /> FMBL824-1 <br /> TO ENSURE PROPER CREDIT, RETURN A COPY OF THIS FORM WITH YOUR REMiT7ANCE T0: <br /> OREGON DEPARTMENT OF TRANSPORTATION <br /> 434 TRANSPORTATION BUILDING <br /> SALEM OR 97310-fl780 <br /> ~ OST-CIfiY -OF EUGENE PUB WORKS <br /> LGIP ACCOUNT #5105-JENNY LYNNES ! FOR INFORMATION CONCERNING <br /> ~ 858 PEARL 4TH FLOOR THIS INVOICE CALL: <br /> EUGENE, OR 97401-2795; (503)986-3956 <br /> - <br /> GENCY T/C CURR. DOC. ~ DOC. DATE VENDOR N0./SUFFIX UNIT <br /> 73 350 0000132910-21 9901 <br /> <br /> i <br /> REVENUE AGENCY CUSTOMER CUSTOMER CUSTOMER <br /> ACCOUNT SOURCE SOURCE AMOUNT DUE AMOUN7 REMITTED REV REFERENCE <br /> RVF10733-Oa0` O1 844814 22 i,719.~0 14248-CON-E` <br /> ~ s <br /> J ~ ~ ~ i. ~Lti ~ E~S6l F~eil <br /> i ti~E3 ~17`t „e CSi~Ft.,,. ,~C~ t~l LJ Lt~~:~F <br /> AMOUNT DUE , <br /> 734-ll58A(1I-88) <br /> <br />