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Oregon Department of Transportation <br /> PAGE N0. 1 <br /> ILLING DATE <br /> 09/DS/99 23:5b <br /> SPORT N0." <br /> FMBL824-1 <br /> TO ENSURE PROPER CREDIT, RETURN A COPY OF TNIS FORM WITH YDUR 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 /> 858 PEARL 4TN FLOOR ~ TNIS INVOICE CALL: <br /> EUGENE OR 97401-2795 C503)9$6-3956 <br /> i <br /> i <br /> i <br /> GENCY T/C CURR. DOC. DOC. DATE VENDOR N0./SUFFIX UNIT <br /> i <br /> 73 350 13291 -b3 99D1 <br /> REVENUE 1sENCY CUSTOMER CUSTOMER CUSTOMER <br /> ACCOUNT SOURCE SOORCE AMOUNT DUE AMOUNT REMITTED REV REFERENCE <br /> i <br /> RVF10310-000 Q1 844020 22- 4.00 11525 - CON <br /> <~a:~9} <br /> y(~ i <br /> \ l V <br /> :4 a <br /> ii IY <br /> ff ~ ~ <br /> [1, Cdl <br /> <br /> 'i. . c~f...ii.\~'St~SSt 2(iLO ~~u Vi~:i <br /> <br /> I <br /> AMOUNT L~U Q::a M> TTANOE>:RE.:~f1ZRED::::?;::::»>:»::~»:<:~:~>>:<:. <br /> ~i4-usaAC a-es ~ <br /> <br />