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Oregon Deparfinent of Transportation - <br /> ~ ~ E PASE N0. 1 <br /> BILLING DATE <br /> O1/05/DO 1:19 <br /> l EPORT N0. <br /> :j 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 /> I i OST-CITY 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 /> I <br /> j AGENCY T/C CURR. DOC. DOC. DATE VENDOR N0./SUFFIX UNIT <br /> 73 350 0000132910-21 9901 <br /> j ACCOUNT REVENUE A6ENCY CUSTCMER CUSTOMER CUSTOMER <br /> SOURCE SOURCE AMOUNT DUE AMOUNT REMITTED REV REFERENCE <br /> RVF1.0733.-000' O1 844Q10 `22 9`j842..57 1.4248'-CON-E'. <br /> <br /> I <br /> . <br /> AMOUNT DUE ..r~----.. <br /> _ <br /> . <br /> ~3»-us6ACU-aa~ <br /> <br />