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Oregon I?epartmentat Transportation <br /> 1? ~ ~ ~ PAGE NO. 1 <br /> BILLING DATE <br /> 05/05/01 .19:49 <br /> REPORT 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 CAPITOL STREET NE, RM434 <br /> SALEM OR 97301-3872 <br /> OST-CITY OF EUGENE PUBLIC WORKS <br /> LGIP ACCOUNT #4909-PEGGY HAMLIN FOR INFORMATION CONCERNING <br /> X858 PEARL 4TH FLOOR THiS INVOICE CALL: <br /> EUGENE OR 97440 (503)986-3956 <br /> I <br /> I <br /> GENCV T/C CURR. DOC. DOC. DATE VENDOR N0./SUFFIX UNIT <br /> 73 350 0000132900-84 9901 <br /> REVENUE AGENCY CUSTOMER CUSTOMER CUSTOMER <br /> ACCOUNT SOURCE SOUecE AMOUNT DUE AMOUNT REMITTED REV REFERENCE <br /> RVF12323-000 O1 $4401U. 21 635..01 17608.- PE' <br /> _ <br /> <br /> I, <br /> ~~~~Q~~~~s~~~Q~~~~ <br /> ~t`~~~ ~~i~~~~~ ~~~st~trl~ <br /> FR YOi1R SCAT€:TR€&SU Y A ~Ju~'~T <br /> AMOUNT DUE ~$~'3~ <br /> 734-S150A(11-SS) - <br /> <br />