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Qragon Department of Transportation <br /> ~ ~ ~ PAGE N0. 1 <br /> ILLIN6 DATE <br /> 06/29/01 20:51 <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 /> 355 CAPITOL STREET NE, RM434 <br /> SALEM OR 97301-3872 <br /> COST-CITY OF EUGENE PUBLIC WORKS <br /> ~ LGIP ACCOUNT #4909-PEGGY HAMLIN ~ FOR INFORMATION CONCERNING <br /> 858 PEARL 4TH FLOOR ~ THIS INVOICE CALL: <br /> EUGENE OR 97440 i (503)98F>-3956 <br /> i <br /> 1 <br /> GENCY T/C CURR. DOC. DOC. DATE VENDOR N0./SUFFIX UNIT <br /> 73 350 0000132900-84 9901 <br /> REVENUE AiENt4 CUSTOMER CUSTOMER CUSTOMER <br /> ACCOUNT - SOURCE SOVRtE AMOUNT DUE AMOUNT REMITTED REV REFERENCE <br /> <br /> I <br /> RVF1:2323=Qu0 QI 8440xa:..' 21:: ,:'~7608`..~_ PE <br /> 652:25 <br /> . <br /> 1;~~t~~~~~~ 0 LY <br /> 7N A~~1t~ A~~~i~vT ~ ~T~1~RRI <br /> ~E~~ ~~13R SfiA~E TREAS ~Y A~Cf~1~lT <br /> AMOU <br /> NT DUE <br /> 734-3350A(31-88) <br /> <br />