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Qregon Department of Transportation <br /> PAGE N0. I <br /> ILLING DATE <br /> 09/08/99 23:56 <br /> EPORT NO. <br /> 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 i FOR INFORMATION CONCERNING <br /> 858 PEARL 4TH FLOOR THIS INVOICE CALL: <br /> EUGENE OR 97401-2795; (503)986-3956 <br /> GENCY T/C CURR. DOG. DOG. DAiE VEN?OR NO./SUFFIX UNIT <br /> 73 350 - 13291 -63 9401 <br /> ACCOUNT REVENUE AGENCY CUSTOMER CUSTOMER REV CUS70MER <br /> SOURCE SOURCE AMOUNT DUE AMOUNT REMITTED REFERENCE <br /> RVF1Q310-Q00 01 84401Q 22 ~ £}.00 11525 - COH <br /> <~a.~9} <br /> ~6r0~+~"~°r 4'..6.33 <br /> { a ` c <br /> 3 t. l _ ' <br /> ~ ' 4 ..r ~ <br /> E <br /> AMOUNT DU Q_:.:}~EMITTANO~;:::~E .UIREfl;...' <br /> <br /> 734-i150AC11-68> <br /> <br />