Oregon Department of Transportation <br /> ' ~I Y ~O ~ V ~ PAGE NO. 1 <br /> BILLING DATE <br /> 04/02/02 19:44 <br /> REPORT 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 /> OST-CITY DF EUGENE PUBLIC WORKS <br /> LGIP ACCOUNT #4909-PEGGY HAMLIN FOR INFORMATION CONCERNING <br /> 858 PEARL 4TH FLOOR THIS INVOICE CALL: <br /> !EUGENE OR 97440 (503)986-3879 <br /> i <br /> I <br /> AGENCY T/C CURR. DOC. DOC. DATE VENDOR NO./SUFFIX UNIT <br /> i <br /> 73 350 0000132900-84 9901 <br /> ACCOUNT REVENUE AGENCY CUSTOMER CUSTOMER REV CUSTOMER <br /> SOURCE SOURCE AMOUNT DUE AMOUNT REMITTED REFERENCE <br /> RVF13470-000 O1 844010 22 261.53 17608 - CON <br /> ~q.~ r <br /> ~ t i _ <br /> k~e~.t X41 ~`i 4,v a~mi 63 V4i8 tj <br /> <br /> 1 <br /> AMOUNT DUE. <br /> 734-1150A(11-EE> <br /> <br />