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Oregon Department of Transportation <br /> ~ ~ ~ ~ PAGE N0. 1 <br /> BILLING DATE <br /> ` 01/05/00 1:19 <br /> EPORT N0. <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 CAPITAL STREET NE, RM434 <br /> SALEM OR 97301-3872 <br /> ( ~ OST-CITY OF EUGENE PUB WORKS <br /> i LGIP ACCOUNT #5105-JENNY LYNNES FOR INFORMATION CONCERNING <br /> ~ ~ 858 PEARL 4TH FLOOR THIS INVOICE CALL: <br /> EUGENE OR 97401-2795 (503)986-395b <br /> i <br /> AGENCY T/C CURR. DOC. DOC. DATE VENDOR N0./SUFFIX UNIT <br /> <br /> I <br /> 73 350 0000132910-21 9901 <br /> AGENCY <br /> <br /> ~ ACCOUNT REVENUE CUSTOMER CUSTOMER REV CUS70MER <br /> SOURCE SOURCE AMOUNT DUE AMOUNT REMITTED REFERENCE <br /> <br /> ~ RVFZ0733-000 O1 `84401:0 22 9,842:..57_ 14248-CON-E". <br /> AMOUNT DUE -~~`f~4~".';'.....E~-,~- <br /> . . <br /> 734-1150A<11-88> <br /> <br />